Parametrium ultrasound in patients with deep endometriosis

S. I. Buryakova, N. A. Altynnik, A. M. Kabeshov
In: Ultrasound & Functional Diagnostics · 2024 · pp. 91–100 · doi:10.24835/1607-0771-268 · W4400935488
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This review examines international guidelines for parametrial ultrasound, demonstrating its capabilities for diagnosing deep endometriosis and planning surgical approaches.

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The paper reviews international recommendations for ultrasound assessment of the parametrial (parametrium) region in the context of deep endometriosis, and illustrates the capabilities of ultrasound by presenting echograms of the parametrium in both normal findings and in deep endometriosis. The high-level focus is on how parametrial endometriosis can involve infiltrative processes affecting pelvic ureters and nerves, with potential downstream implications for urinary and intestinal function and sexual function, which makes detailed preoperative diagnostics important for planning complex multidisciplinary surgery. As a stated limitation, the article functions as a recommendations-and-illustrations review rather than providing new diagnostic accuracy data in a defined study cohort. This paper is centrally about endometriosis — it specifically addresses ultrasound visualization and evaluation of parametrial involvement in deep endometriosis, including representative echographic findings.

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Abstract

Parametrial endometriosis is a severe form of the disease associated with the involvement of the ureters and pelvic nerves, which leads to sexual, urinary, and intestine dysfunction. Surgery in such cases requires a complex multidisciplinary approach, which can be planned only with a detailed preoperative diagnosis. The article presents a review of current international guidelines for parametrium ultrasound. The capabilities of ultrasound are demonstrated by our own ultrasound images of normal parametrium and in deep endometriosis.
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Ультразвуковое исследование параметрия у пациенток с глубоким эндометриозом https://doi.org/10.24835/1607-0771-268 Аннотация Эндометриоз параметрия представляет собой тяжелую форму заболевания, связанную с вовлечением в инфильтративный процесс мочеточников и нервов малого таза, что может приводить к нарушениям функций мочевыделительной системы, кишечника и сексуальной дисфункции. Хирургическое вмешательство в таких случаях требует сложного мультидисциплинарного подхода, планирование которого возможно только после детальной предоперационной диагностики. В статье приводится обзор современных международных рекомендаций по ультразвуковой оценке параметрия. Для демонстрации возможностей ультразвукового исследования представлены собственные эхограммы параметрия в норме и при глубоком эндометриозе. Об авторах С. И. БуряковаРоссия Бурякова Снежана Игоревна – канд. мед. наук, доцент кафедры ультразвуковой и пренатальной диагностики Академии постдипломного образования ФГБУ ФНКЦ ФМБА России, Москва Н. А. Алтынник Россия Алтынник Наталья Анатольевна – доктор мед. наук, профессор, заведующая кафедрой ультразвуковой и пренатальной диагностики Академии постдипломного образования ФГБУ ФНКЦ ФМБА России, Москва А. М. Кабешов Россия Кабешов Александр Михайлович – хирург Центра хирургии эндометриоза, ООО “Клиника Фомина Мичуринский”, Москва Список литературы 1. Whitaker L.H.R., Byrne D., Hummelshoj L. et al. Proposal for a new ICD-11 coding classification system for endometriosis. Eur. J. Obstet. Gynecol. Reprod. Biol. 2019; 241: 134–135. http://doi.org/10.1016/j.ejogrb.2019.08.015 2. Johnson N.P., Hummelshoj L., Adamson G.D. et al. World Endometriosis Society consensus on the classification of endometriosis. Hum. Reprod. 2017; 32 (2): 315–324. http://doi.org/10.1093/humrep/dew293 3. 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Scand. 2021; 100 (7): 1165–1175. http://doi.org/10.1111/aogs.14099 31. Leonardi M., Martins W.P., Espada M. et al. Proposed technique to visualize and classify uterosacral ligament deep endometriosis with and without infiltration into parametrium or torus uterinus. Ultrasound Obstet. Gynecol. 2020; 55 (1): 137–139. http://doi.org/10.1002/uog.20300 32. Szabó G., Madár I., Hudelist G. et al. Visualization of sacral nerve roots and sacral plexus on gynecological transvaginal ultrasound: feasibility study. Ultrasound Obstet. Gynecol. 2023; 62 (2): 290–299. http://doi.org/10.1002/uog.26204 Рецензия Для цитирования: Бурякова С.И., Алтынник Н.А., Кабешов А.М. Ультразвуковое исследование параметрия у пациенток с глубоким эндометриозом. Ультразвуковая и функциональная диагностика. 2024;(2):91-100. https://doi.org/10.24835/1607-0771-268 For citation: Buryakova S.I., Altynnik N.A., Kabeshov A.M. Parametrium ultrasound in patients with deep endometriosis. Ultrasound & Functional Diagnostics. 2024;(2):91-100. (In Russ.) https://doi.org/10.24835/1607-0771-268 JATS XML

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