OP11.08: Transvaginal ultrasound versus magnetic resonance in the study of under‐diagnosed endometriosis: adenomyosis and deep endometriosis

To evaluate the accuracy of TVS vs. magnetic resonance imaging (MRI) for the diagnosis of adenomyosis and recto-vaginal endometriosis. Twelve patients with adenomyosis and 20 with endometriosis of the recto-vaginal septum were selected and followed by TVS and MRI before surgery. Sonographic features of adenomyosis include myometrial heterogeneity, asymmetric thickening of myometrium, cysts, linear striations, and an ill-defined endometrium; recto-vaginal endometriosis appears as an infiltration of the recto-vaginal septum by endometriotic nodules or linear striations. The larger nodules can adhere to the anterior rectal wall. MRI showed the typical well-known appearance. TVS diagnosis of adenomyosis and recto-vaginal endometriosis is possible, but it has to be searched for, is not easy to do and could be operator dependent. The specific features of adenomyosis and recto-vaginal endometriosis on TVS give a non-invasive diagnosis with a high degree of accuracy, thereby reducing the costs and delays associated with MRI and avoiding unnecessary invasive procedures.