Clinical Cases and Videos

In: How to Perform Ultrasonography in Endometriosis · 2018 · pp. 185–190 · doi:10.1007/978-3-319-71138-6_17 · W2897367179
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This paper presents clinical cases and videos illustrating deep endometriosis diagnosed by transvaginal ultrasound, emphasizing the need for standardized methods by experienced operators as defined by the IDEA group.

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This chapter addresses how to diagnose deep endometriosis (DE) with transvaginal ultrasound (TVS), emphasizing that the technique is operator-dependent and should be performed in a standardized way by an experienced operator. It reviews in detail a consensus approach published by the International Deep Endometriosis Analysis (IDEA) group, describing terms, definitions, and measurements for systematic sonographic evaluation. A key limitation explicitly noted is that optimization depends on standardization and operator expertise, rather than being fully reproducible across different examiners. This paper is centrally about endometriosis — it focuses on standardized TVS evaluation for deep endometriosis (and associated sonographic findings) as part of a practical ultrasonography guidance.

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Abstract

The diagnosis of deep endometriosis (DE) using transvaginal ultrasound (TVS) is an operator-dependent technique. For this method to be optimized, it must be done in a standardized way by an experienced operator. This standard approach in obtaining and analyzing the images has been recently published by a group of world experts, the International Deep Endometriosis Analysis (IDEA) group, and this consensus statement is reviewed in detail in Chap. 3 [1]. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

Reference

Guerriero S, Condous G, van den Bosch T, Valentin L, Leone FP, Van Schoubroeck D, Exacoustos C, Installé AJ, 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):318–32. https://doi.org/10.1002/uog.15955. Epub 2016 Jun 28. PubMed PMID: 27349699. Author information Authors and Affiliations Editor information Editors and Affiliations 17.1 Electronic Supplementary Material Complete septate uterus, rectovaginal nodule with involvement of vaginal posterior wall, uterosacral ligaments, and anterior rectum wall (diabolo-like nodule) (MOV 56093 kb) Presence of negative sliding sign in the anterior compartment (obliteration of uterovesical region). Also can be observed a uterovesical region nodule of 12 × 10 × 12 mm. In the posterior compartment, it is possible to observe a nodule of 16 × 9 × 12 mm with involvement of left uterosacral ligament insertion (MOV 88035 kb) Presence of fixed ovaries, right atypical endometrioma with solid component without vascularization. Corpus luteum in the left ovary and presence of two anterior rectal wall nodules of 12 × 11 × 8 mm and 13 × 7 × 9 mm, respectively (multifocal lesions). Also, it can be observed another lesion of 14 × 10 × 11 mm in between both rectal lesions. Negative sliding sign in the posterior compartment (MOV 67710 kb) Multifocal compromise of rectosigmoid with anterior rectal wall nodules with complete septate uterus. In addition, you can observe another lesion with compromise of the left uterosacral ligament and posterior vaginal wall (MOV 72082 kb) The measurement of anterior rectal wall nodule was 22 × 9 × 14 mm, without involvement of submucosa. Another lesion of 14 × 9 × 10 mm, fixed to the previous one, involving the uterosacral ligaments was found (MOV 29214 kb) Bladder dome nodule of 10 × 7 × 10 mm. Ureteral intravesical segment nodule (extrinsic compromise) of 18 × 9 × 10 mm (MOV 54355 kb) Bladder base intramural nodule of 19 × 20 × 21 mm, without compromise of intravesical ureters. Also can be observed a right uterosacral ligament nodule of 9 × 6 × 7 mm, fixed to the posterior vaginal wall (MOV 42757 kb) A rectosigmoid anterior rectal wall nodule of 43 × 13 × 14 mm with involvement of vagina and uterosacral ligament. In addition, you can observe another lesion of 16 × 16 × 11 mm (MOV 54452 kb) At seven centimeters from the anal verge, it can be seen a rectosigmoid anterior rectal wall nodule with involvement of vagina and uterosacral ligaments of 42 × 7 × 19 mm. Also you can observe vaginal lesion of 17 × 8 × 12 mm (MOV 31560 kb) Retroverted uterus. A rectosigmoid anterior rectal wall nodule with transmural compromise with involvement of submucosa of 30 × 10 × 22 mm. It can be observed a lesion involving the uterosacral ligaments with superficial vaginal involvement (MOV 63761 kb) Rights and permissions Copyright information © 2018 Springer International Publishing AG, part of Springer Nature About this chapter Cite this chapter León, M., Sovino, H., Alcazar, J.L. (2018). Clinical Cases and Videos. In: Guerriero, S., Condous, G., Alcázar, J.L. (eds) How to Perform Ultrasonography in Endometriosis. Springer, Cham. https://doi.org/10.1007/978-3-319-71138-6_17 Download citation DOI: https://doi.org/10.1007/978-3-319-71138-6_17 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-71137-9 Online ISBN: 978-3-319-71138-6 eBook Packages: MedicineMedicine (R0)

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