Enzian classification in preoperative ultrasound examination and intraoperative staging of endometriosis

Yu.I. Sopova, А.А. Popov, S.G. Mamedova
In: Russian Bulletin of Obstetrician-Gynecologist · 2025 · vol. 25(5) , pp. 75 · doi:10.17116/rosakush20252505175 · W4415419113
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This study retrospectively analyzed 106 patients, finding preoperative ultrasound accurately correlates with intraoperative Enzian classification of endometriosis, particularly for rectal infiltrates and ovarian involvement.

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The study evaluated how well Enzian classification can be determined using preoperative ultrasound imaging and how that classification aligns with intraoperative staging in patients with endometriosis. In women undergoing ultrasound assessment for suspected disease, lesions were categorized according to Enzian components prior to surgery and then compared with the operative findings used for staging, focusing on deep endometriosis extent. The authors reported concordance outcomes between sonography-based Enzian staging and intraoperative assessment, indicating the feasibility of Enzian structured description in the preoperative setting. A key limitation noted is that ultrasound-based classification may differ from surgical staging depending on lesion detectability and other practical constraints of imaging. This paper is centrally about endometriosis — it investigates Enzian classification in preoperative ultrasound examination and intraoperative staging of endometriosis.

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Abstract

Objective. To compare the size and localization of endometrioid foci, to compare the severity of the adhesive process in the small pelvis, assessed using preoperative ultrasound and intraoperative staging according to the Enzian classification. Materials and methods. A retrospective analysis of the data of 106 patients who underwent surgery in a specialized center for infiltrative endometriosis was performed. Results. The informative value of ultrasound in detecting rectal infiltrates (Enzian C) showed the highest level of compliance with intraoperative diagnosis in 94.3% of cases. For division B (uterosacral ligaments, parametrium) and division A (vagina, rectovaginal ligament), concordance rates were slightly lower — 79.2% and 88.7%, respectively. In department O (ovaries), high accurate rates of coincidence with the results of intraoperative staging were observed, similar to those established for Compartment C. The diagnosis of the lesion of the T division (tubular complex) was the most difficult. The largest number of observations of the correct diagnosis of adhesions of the ovarian tissue, fallopian tube and underlying structures was revealed in severe adhesions (T3). Conclusion. The preoperative assessment of the localization and size of endometrioid foci using ultrasound in various departments according to the Enzian classification is highly accurate and provides a detailed preoperative description of the prevalence of endometriosis.
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Сайт издательства «Медиа Сфера» содержит материалы, предназначенные исключительно для работников здравоохранения. Закрывая это сообщение, Вы подтверждаете, что являетесь дипломированным медицинским работником или студентом медицинского образовательного учреждения. Результаты поиска: 0 Классификация Enzian в предоперационном ультразвуковом исследовании и интраоперационном стадировании эндометриоза Журнал: Российский вестник акушера-гинеколога. 2025;25(5): 75‑80 Прочитано: 704 раза Как цитировать: Литература / References: - Chapron C, Dubuisson JB. Management of deep endometriosis. Ann N Y Acad Sci. 2001;943:276-280. https://doi.org/10.1016/s1297-9589(03)00045-6 - Koninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril. 1991;55:759-765. https://doi.org/10.1016/s0015-0282(16)54244-7 - Fedele L, Bianchi S, Raffaelli R, Portuese A. Pre-operative assessment of bladder endometriosis. Hum Reprod. 1997;12:2519-2522. https://doi.org/10.1093/humrep/12.11.2519 - Keckstein J, Wiesinger H. Deep endometriosis, including intestinal involvement — the interdisciplinary approach. Minim Invasive Ther Allied Technol. 2005;14:160-166. https://doi.org/10.1080/14017430510035916 - Keckstein J, Ulrich U, Possover M, Schweppe KW. ENZIAN-Klassifikation der tief infiltrierenden Endometriose. Zentralbl Gynakol. 2003;125:291-309. - Keckstein J, Saridogan E, Ulrich UA, Sillem M, Oppelt P, Schweppe KW, Krentel H, Janschek E, Exacoustos C, Malzoni M, Mueller M, Roman H, Condous G, Forman A, Jansen FW, Bokor A, Simedrea V, Hudelist G. The #Enzian classification: A comprehensive non-invasive and surgical description system for endometriosis. Acta Obstet Gynecol Scand. 2021;100:7:1165-1175. https://doi.org/10.1111/aogs.14099 - Guerriero S, Condous G, van den Bosch T, Valentin L, Leone FPG, Van Schoubroeck D, Exacoustos C, Installé AJF, Martins WP, Abrao MS, Hudelist G, Bazot M, Alcazar JL, Gonçalves MO, Pascual MA, Ajossa S, Savelli L, Dunham R, Reid S, Menakaya U, Bourne T, Ferrero S, Leon M, Bignardi T, Holland T, Jurkovic D, Benacerraf B, Osuga Y, Somigliana E, Timmerman D. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol. 2016;48:3:318-332. https://doi.org/10.1002/uog.15955 - Hudelist G, Montanari E, Salama M, Dauser B, Nemeth Z, Keckstein J . Comparison between Sonography-based and Surgical Extent of Deep Endometriosis Using the Enzian Classification — A Prospective Diagnostic Accuracy Study. J Minim Invasive Gynecol. 2021;28;9;1643-1649.e1. https://doi.org/10.1016/j.jmig.2021.02.009 - Daniilidis A, Grigoriadis G, Dalakoura D, D’Alterio MN, Angioni S, Roman H. Transvaginal ultrasound in the diagnosis and assessment of endometriosis-an overview: How, why, and when. Diagnostics (Basel). 2022;12:12:2912. https://doi.org/10.3390/diagnostics12122912 - Burla L, Scheiner D, Samartzis EP, Seidel S, Eberhard M, Fink D, Boss A, Imesch P. The ENZIAN score as a preoperative MRI-based classification instrument for deep infiltrating endometriosis. Arch Gynecol Obstet. 2019;300:1:109-116. https://doi.org/10.1007/s00404-019-05157-1 - Indrielle-Kelly T, Fanta M, Frühauf F, Burgetová A, Cibula D, Fischerová D. Are we better off using multiple endometriosis classifications in imaging and surgery than settle for one universal less than perfect protocol? Review of staging systems in ultrasound, magnetic resonance and surgery. J Obstet Gynaecol. 2022;42:1:10-16. https://doi.org/10.1080/01443615.2021.1887111 - Bäumler M, Heiss N, Druckmann R. Endometriosis at all ages: diagnostic ultrasound. Horm Mol Biol Clin Investig. 2022;43:2: 151-157. https://doi.org/10.1515/hmbci-2021-0082 - Canis M, Bouquet De Jolinières J, Wattiez A, Pouly JL, Mage G, Manhes H, Bruhat MA. Classification of endometriosis. Baillieres Clin Obstet Gynaecol. 1993;7:4:759-774. https://doi.org/10.1016/s0950-3552(05)80462-6 - Lee SY, Koo YJ, Lee DH. Classification of endometriosis. Yeungnam Univ J Med. 2021;38:1:10-18. https://doi.org/10.12701/yujm.2020.00444 - Di Giovanni A, Montanari E, Hudelist G, Malzoni M, Keckstein J. Comparison between sonography-based and surgical evaluation of endometriotic lesions using the #Enzian Classification — A Retrospective data analysis. Ultraschall Med. 2023;44:3:290-298. https://doi.org/10.1055/a-1713-3573 - Moro F, Leombroni M, Testa AC. Ultrasound imaging in endometriosis. Obstet Gynecol Clin North Am. 2019;46:4:643-659. https://doi.org/10.1016/j.ogc.2019.07.004 - Wang PH, Yang ST, Chang WH, Liu CH, Lee FK, Lee WL. Endometriosis: Part I. Basic concept. Taiwan J Obstet Gynecol. 2022; 61:6:927-934. https://doi.org/10.1016/j.tjog.2022.08.002 - Metzemaekers J, Blikkendaal MD, V Nieuwenhuizen KE, Bronsgeest K, Rhemrev JPT, Smeets MJGH, English J, Jansen FW, Both S, Twijnstra ARH. Preoperative pain measurements in correlation to deep endometriosis classification with Enzian. Facts Views Vis Obgyn. 2022;14:3:245-253. https://doi.org/10.52054/FVVO.14.3.034 - Manganaro L, Celli V, Dolciami M, Ninkova R, Ercolani G, Ciulla S, De Vito C, Rizzo SM, Porpora MG, Catalano C. Can New ENZIAN Score 2020 represent a staging system improving MRI structured report? Int J Environ Res Public Health. 2021;18:19:9949. https://doi.org/10.3390/ijerph18199949 - Leonardi M, Condous G. How to perform an ultrasound to diagnose endometriosis. Australas J Ultrasound Med. 2018;21:2:61-69. https://doi.org/10.1002/ajum.12093 Подтверждение e-mail На [email protected] отправлено письмо со ссылкой для подтверждения e-mail. Перейдите по ссылке из письма, чтобы завершить регистрацию на сайте. Подтверждение e-mail Мы используем файлы cооkies для улучшения работы сайта. Оставаясь на нашем сайте, вы соглашаетесь с условиями использования файлов cооkies. Чтобы ознакомиться с нашими Положениями о конфиденциальности и об использовании файлов cookie, нажмите здесь.

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Outcome instruments

Enzian

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endometriosis

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