Ultrasound Use with Endometriosis

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While endometriosis cannot be conclusively diagnosed using ultrasound, it can be useful in ruling in/out other conditions and giving clinical data before further treatment. Ultrasounds might be useful in detecting endometriomas or deep-infiltrating endometriosis. This can enable the surgeon to have the best team prepared for surgery. It is important to have a team who knows the correct protocol for imaging and for reading the images. 

Studies:

“Objective: The objective of this study is to evaluate the sensitivity of routine trans vaginal ultrasound (TVUS) compared to expert-guided transvaginal ultrasound (ETVUS) for the diagnosis of endometriosis….Conclusions: ETVUS is more sensitive than routine TVUS to diagnose endometriosis, identifying lesions other than endometrioma and is of assistance in surgical planning and patient counseling.”

  • Guerriero, S., Saba, L., Pascual, M. A., Ajossa, S., Rodriguez, I., Mais, V., & Alcazar, J. L. (2018). Transvaginal ultrasound vs magnetic resonance imaging for diagnosing deep infiltrating endometriosis: systematic review and meta‐analysis. Ultrasound in Obstetrics & Gynecology51(5), 586-595.  Retrieved from https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.18961  

“Conclusion: The diagnostic performance of TVS and MRI is similar for detecting DIE involving rectosigmoid, uterosacral ligaments and rectovaginal septum.”

  • Menakaya, U., Reid, S., Lu, C., Bassem, G., Infante, F., & Condous, G. (2016). Performance of ultrasound‐based endometriosis staging system (UBESS) for predicting level of complexity of laparoscopic surgery for endometriosis. Ultrasound in obstetrics & gynecology48(6), 786-795.  Retrieved from https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.15858 

“This was a multicenter prospective and retrospective cohort study on consecutive women with suspected endometriosis who underwent laparoscopy between June 2009 and July 2013. Each woman underwent a systematic transvaginal ultrasound evaluation to assess the pelvis for different phenotypes of endometriosis, and the diagnostic performance of ultrasound for these different phenotypes was evaluated relative to the gold standard, laparoscopy….Conclusion: UBESS could be utilized to predict the level of complexity of laparoscopic surgery for endometriosis. It has the potential to facilitate the triage of women with suspected endometriosis to the most appropriate surgical expertise required for laparoscopic endometriosis surgery.”