Localizarea ultrasonografică a implantelor endometriozice

Objectives. Assessment of key endometriosis diagnostic ultrasound techniques, highlighting technique, advantages and limitations of each method. Method. We reviewed the literature for different methods of ultrasound diagnosis of endometriosis and selected representative articles. In each study, final diagnosis of endometriosis was established on laparoscopy and/or histopathological examination. Results. We included 16 studies that investigated the use of ultrasonographyin the endometriosis diagnosis. Of these, 13 were prospective studies, a prospective studybased on personal cases, a presentation of a ultrasound technique (sonorectovaginography) and a review study that researched the accuracy of recto-sigmoid deep infiltrative endometriosis diagnosis by transvaginal ultrasound (TVS). Data was analyzed by comparing statistical indicators for every sonographic investigation: prevalence, sensitivity, specificity, positive and negative predictive value. Conclusion. TVS stands as the first choice investigation for non-invasive diagnosis of endometriosis. TVS has an increased accuracy in detecting lesions of the ovaries, bladder and recto-sigmoid. TVS with water contrastin the rectum (RWC-TVS) and sonovaginography prove to be more useful in detecting recto-vaginal lesions and are recommended to be used in cases where TVS can not exclude rectum infiltration. Transrectal ultrasound indications are limited to cases with a significant discrepancy between the results of clinical examination and TVS and is considered to be the best technique for evaluating the craniocaudal extension of rectal endometriosis. Gel sonovaginography and sonorectovaginography are effective diagnostic methods of endometriosis of the recto-sigmoid and posterior compartment.