Imaging and surgical mapping in endometriosis

Endometriosis is a chronic estrogen-dependent disease with inflammatory potential, characterized by the presence of ectopic endometrial tissue outside the uterus, with poly­mor­phic and multifocal characteristics. In the same patient, there may be present several types of endometriotic lesions – from superficial endometriosis to endometriomas and deep infiltrative endometriosis. We can even say that it is a fi­bro­tic condition in which the stroma and the endometrial epi­the­lium are identified. Materials and method. We con­duc­ted a retrospective study, between 2017 and 2021, on a group of 126 patients, aged between 25 and 50 years old, operated in the “Prof. Dr. Panait Sîrbu” Clinical Hospital of Obstetrics and Gynecology, Bucharest, the Euroclinic Hos­pi­tal – Private Health Network, and Monza Hospital, Bucha­rest. Results. We performed a comparative study of the diagnosis of ultrasound endometriosis/MRI and in­tra­ope­ra­tive endometriosis. According to information, the MRI diag­no­sis of endometriosis lesions is clearly superior, having a higher accuracy compared to the ultrasound diagnosis. Conclusions. There is no imaging method that can be used in­di­vidually and be effective enough to identify the location and extent of endometriosis. The performance of these ima­ging procedures should be considered depending on the type of suspected endometriosis, the proposed therapeutic stra­te­gy, and the information to be provided to the patient. Trans­va­gi­nal ultrasound is a repeatable, costless procedure that can be used to diagnose certain types and locations of endometriosis. The role of transvaginal ultrasound is to guide the type of subsequent complementary investigations depen­ding on the location of the lesions, when suspected.