Ultrasonography of pelvic endometriosis

Juan A. García-Velasco, Maria Cerrillo, Rosario Cerrillo Martín, Lía Ornat
In: Ultrasonography in Reproductive Medicine and Infertility · 2010 · pp. 119–125 · doi:10.1017/cbo9780511776854.017 · W764400307
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Power Doppler and 3D ultrasound with VOCAL effectively evaluate ovarian vascularity, diagnose uterine pathologies like leiomyomas and polyps, and aid in early ectopic pregnancy detection.

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This chapter evaluates the diagnostic utility of transvaginal sonography for pelvic endometriosis, noting that while ovarian endometriomas are readily identifiable, the technique exhibits low sensitivity for deep infiltrating lesions in the vaginal or rectovaginal septum. The authors highlight that associated functional abnormalities in infertile women may complicate oocyte retrieval and acknowledge that magnetic resonance imaging offers superior diagnosis for extraovarian disease and adenomyosis due to lower interobserver variability. Relevance to endometriosis: Centrally about the condition, specifically focusing on the limitations and capabilities of ultrasonography in diagnosing various forms of pelvic endometriosis and distinguishing it from adenomyosis.

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Abstract

Power Doppler ultrasound (US), in combination with three-dimensional US and virtual organ computer-aided analysis (VOCAL), is a very good approach for investigating the global ovarian vascular network and its correlation with ovarian response in assisted reproductive technology (ART). An ovarian vascular map is easily obtained from a sagittal section of the ovary. Three-dimensional US has become a key tool for diagnosing uterine malformations. Leiomyomas and endometrial polyps are the most frequent benign uterine pathologies, and both can interfere with the reproductive process. The human endometrium undergoes intense angiogenesis during menstrual cycle, and angiogenesis is a key process for successful embryo implantation and development. In reproductive medicine, it is crucial to exclude ectopic pregnancy as early as possible. 3D US is a more accurate technique for evaluating the relationship between the gestational sac and uterine septum and for differentiating between a cornual pregnancy and a displaced intracavitary pregnancy.
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- Ultrasonography in Reproductive Medicine and Infertility - Ultrasonography in Reproductive Medicine and Infertility - Copyright page - Dedication - Contents - Contributors - Foreword - Preface - Acknowledgments - Section 1: Imaging techniques - Section 2: Ultrasonography in infertility - Chapter 8 3D Ultrasonography and infertility - Chapter 9 Ultrasonography and diagnosis of polycystic ovary syndrome - Chapter 10 Ultrasonography and the treatment of infertility in polycystic ovary syndrome - Chapter 11 Ultrasonography of uterine fibroids - Chapter 12 Ultrasonography of the endometrium - Chapter 13 Ultrasonography of the cervix - Chapter 14 Color Doppler imaging of ovulation induction - Chapter 15 Ultrasonography of pelvic endometriosis - Chapter 16 Adenomyosis - Chapter 17 Congenital uterine malformations - Chapter 18 Uterine septum - Chapter 19 Ultrasonography and incidental ovarian pathology - Chapter 20 Scrotal ultrasonography in male infertility - Chapter 21 Transrectal ultrasonography in male infertility - Chapter 22 Ultrasonographic evaluation of acute pelvic pain - Chapter 23 Ultrasonographic evaluation of chronic pelvic pain - Section 3: Ultrasonography in assisted reproduction - Section 4: Early pregnancy after infertility treatment - Index from Section 2: - Ultrasonography in infertility Published online by Cambridge University Press: 07 September 2011 Edited by Book contents - Ultrasonography in Reproductive Medicine and Infertility - Ultrasonography in Reproductive Medicine and Infertility - Copyright page - Dedication - Contents - Contributors - Foreword - Preface - Acknowledgments - Section 1: Imaging techniques - Section 2: Ultrasonography in infertility - Chapter 8 3D Ultrasonography and infertility - Chapter 9 Ultrasonography and diagnosis of polycystic ovary syndrome - Chapter 10 Ultrasonography and the treatment of infertility in polycystic ovary syndrome - Chapter 11 Ultrasonography of uterine fibroids - Chapter 12 Ultrasonography of the endometrium - Chapter 13 Ultrasonography of the cervix - Chapter 14 Color Doppler imaging of ovulation induction - Chapter 15 Ultrasonography of pelvic endometriosis - Chapter 16 Adenomyosis - Chapter 17 Congenital uterine malformations - Chapter 18 Uterine septum - Chapter 19 Ultrasonography and incidental ovarian pathology - Chapter 20 Scrotal ultrasonography in male infertility - Chapter 21 Transrectal ultrasonography in male infertility - Chapter 22 Ultrasonographic evaluation of acute pelvic pain - Chapter 23 Ultrasonographic evaluation of chronic pelvic pain - Section 3: Ultrasonography in assisted reproduction - Section 4: Early pregnancy after infertility treatment - Index Ovarian cystic endometriosis, endometrioma, may present on ultrasonography as an easily identifiable hyper-refringent adnexal mass and the most frequent variation. Different studies have tried to evaluate the diagnostic capacity of transvaginal sonography (TVS) in deep endometriosis. When ultrasonographic findings were compared with surgical findings and pathology reports, a low sensitivity (around 30%) was reported for vaginal or rectovaginal septum endometriosis, with a high rate of false negatives. Infertile women with endometriosis have a higher prevalence of associated functional images, such as unruptured luteinized follicles, hydrosalpinges, adenomyosis, and/or intraovarian endometriosis that may interfere with oocyte retrieval. The role of TVS in the diagnosis of extraovarian endometriosis, an area where magnetic resonance imaging (MRI) has proved to be much more beneficial, is yet to be established. MRI offers a better suggestive diagnosis of adenomyosis than TVS due to its lower interobserver variability. - Type - Chapter - Information - Ultrasonography in Reproductive Medicine and Infertility , pp. 119 - 125Publisher: Cambridge University PressPrint publication year: 2010 Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future. - 1 - Cited by To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. 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endometriosis

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