Keywords
Genital / Reproductive system female, Ultrasound, Screening, Quality assurance
Authors:
K. Berrada, O. Mariya, I. MIARA, H. Tabakh, A. Siwane, N. Touil, O. Kacimi, N. Chikhaoui
DOI:
10.26044/ecr2023/C-22790
Learning objectives
Endometriosis is a chronic gyneacological condition affecting approximately 1 per 10 women, defined as the presence of endometrial glands and stromalike lesions outside the uterus. [1] The disease mainly affects the pelvis, in particular the ovaries, pelvic peritoneum, pouch of Douglas, rectum, rectosigmoid, rectovaginal septum, uterosacral ligaments (USLs), vagina and urinary bladder. [2] It can manifest itself in chronic pelvic pain or infertility. MRI is known to have a high sensitivity and specificity in diagnosing pelvic endometriosis. Ultrasonography (especially transvaginal), when well performed, has become...
Background
Using PubMed database with MeSh terms [endometriosis] and [ultrasonography], 12 (out of a total of 39) evidence-based medical articles published from 2007 to the present were selected.
Findings and procedure details
Atlas of ultrasonographic images concerning endometriosis :
Typical endometrioma : unilocular or multilocular (less than 5 locules) cyst, with homogeneous low-level echogenicity (ground glass echogenicity) of the cyst fluid. Usually poorly vascularised (power or color Doppler) [3], mostly found within the ovary.[Fig 1]
More than one endometrioma can be found : [Fig 2]
When endometrimas are bilateral with both ovaries adherent to each other , they realize the Kissing ovaries sign.[Fig 3]
Ovarian endometrioma can appear as a unilocular cyst with ground glass echogenicity, with...
Conclusion
To sum up, transvaginal ultrasonography is an essential and accessible tool in the diagnosis of endometriosis. It can provide a detailed description of the extent and severity of the disease.
The International Deep Endometriosis Analysis group (IDEA) suggests a systematic ultrasonography approach consistingin four basic steps :
1) Routine evaluation of uterus and adnexa (+ sonographic signs of adenomyosis/endometrioma)
2) Evaluation of transvaginal sonographic ‘soft markers’ (i.e. site-specific tenderness and ovarian mobility) {Dynamic}
3) Assessment of status of Pouch of Douglas (POD) using real-time ultrasound-based...
Personal information and conflict of interest
K. Berrada:
Nothing to disclose
O. Mariya:
Nothing to disclose
I. MIARA:
Nothing to disclose
H. Tabakh:
Nothing to disclose
A. Siwane:
Nothing to disclose
N. Touil:
Nothing to disclose
O. Kacimi:
Nothing to disclose
N. Chikhaoui:
Nothing to disclose
References
[1] A. Deslandes, N. Parange, J. T. Childs, B. Osborne, et E. Bezak, «Current Status of Transvaginal Ultrasound Accuracy in the Diagnosis of Deep Infiltrating Endometriosis Before Surgery: A Systematic Review of the Literature», J Ultrasound Med, vol. 39, no 8, p. 1477‑1490, août 2020, doi: 10.1002/jum.15246.
[2] S. Guerriero et al., «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 in Obstetrics &...
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