OP07.09: Ultrasound characteristics of the abdominal wall endometriosis

L. Jokubkiene, Tove Olsson Brandtvig, P. Sladkevicius
In: Ultrasound in Obstetrics & Gynecology · 2024 · vol. 64(S1) , pp. 78 · doi:10.1002/uog.27932 · PMID:39250094 · W4402357809
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This study described ultrasound characteristics of abdominal wall endometriosis lesions, finding irregular margins, microcysts, and scarce vascularization were common, while shadowing was less frequent.

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This study examined the ultrasound characteristics of abdominal wall endometriosis in 56 patients using transabdominal and transvaginal imaging techniques between 2014 and 2024. The results indicated that most lesions presented with irregular margins, microcysts, and minimal to no vascularization, while shadowing was a less frequent finding. Additionally, the research noted that approximately one-fifth of the cohort had concomitant adenomyosis or other forms of pelvic endometriosis. This paper is centrally about endometriosis — specifically the sonographic features and diagnostic criteria for abdominal wall endometriosis.

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Abstract

To describe ultrasound characteristics of abdominal wall endometriosis (AWE). Patients with AWE were examined at the Ultrasound Unit, Department of Obstetrics and Gynecology in 2014-2024 using transabdominal and transvaginal ultrasound. Size, location, gray-scale (regularity of margins, presence of microcysts and shadowing) and Doppler ultrasound (colour score) morphology of AWE lesions were described. Presence of adenomyosis, ovarian or deep endometriosis noted. In all, 56 patients were included. Mean size of the lesions was 19.9mm (±8.08). At ultrasound examination, 8 (14.3%) lesions were judged to be subcutaneous, 32 (57.1%) to involve fascia and subcutaneous tissues, 11 (19.6%) to involve abdominal wall muscles, 3 (5.4%) to involve abdominal wall muscles and fascia and the remaining 2 (3.6%) lesions in the umbilicus. Median length of the fascia involvement was 18.4 (12.0-24.5) mm. In total, 45 (80.4%) of the lesions had irregular margins, 38 (67.9%) had microcysts, 17 (30.4%) had shadowing, 33 (58.9%) had no vascularisation and 16 (28.2%) had scarce vascularisation. Of all patients, 12 (21.4%) had adenomyosis and/or endometriosis: 5 (9.3%) had adenomyosis and 8 (14.2%) had endometriosis (5 (8.9%) ovarian endometriosis and 7 (12.5%) deep endometriosis in the pelvis). Endometriosis diagnosis was confirmed by histology after fine needle punction in 18 (64.3%), after true-cut biopsy in 5 (8.9%) and excision of the lesion in 36 (65.5%) women. Majority of AWE lesions appear as lesions with irregular margins, containing microcysts and have none or scarce vascularisation. Shadowing is less common sign. One in five patients has concomitant adenomyosis or endometriosis.
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Objectives

To describe ultrasound characteristics of abdominal wall endometriosis (AWE).

Methods

Patients with AWE were examined at the Ultrasound Unit, Department of Obstetrics and Gynecology in 2014-2024 using transabdominal and transvaginal ultrasound. Size, location, gray-scale (regularity of margins, presence of microcysts and shadowing) and Doppler ultrasound (colour score) morphology of AWE lesions were described. Presence of adenomyosis, ovarian or deep endometriosis noted.

Results

In all, 56 patients were included. Mean size of the lesions was 19.9mm (±8.08). At ultrasound examination, 8 (14.3%) lesions were judged to be subcutaneous, 32 (57.1%) to involve fascia and subcutaneous tissues, 11 (19.6%) to involve abdominal wall muscles, 3 (5.4%) to involve abdominal wall muscles and fascia and the remaining 2 (3.6%) lesions in the umbilicus. Median length of the fascia involvement was 18.4 (12.0-24.5) mm. In total, 45 (80.4%) of the lesions had irregular margins, 38 (67.9%) had microcysts, 17 (30.4%) had shadowing, 33 (58.9%) had no vascularisation and 16 (28.2%) had scarce vascularisation. Of all patients, 12 (21.4%) had adenomyosis and/or endometriosis: 5 (9.3%) had adenomyosis and 8 (14.2%) had endometriosis (5 (8.9%) ovarian endometriosis and 7 (12.5%) deep endometriosis in the pelvis). Endometriosis diagnosis was confirmed by histology after fine needle punction in 18 (64.3%), after true-cut biopsy in 5 (8.9%) and excision of the lesion in 36 (65.5%) women.

Conclusions

Majority of AWE lesions appear as lesions with irregular margins, containing microcysts and have none or scarce vascularisation. Shadowing is less common sign. One in five patients has concomitant adenomyosis or endometriosis.

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endometriosisadenomyosis

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