Keywords:
Education, Ultrasound, MR, Pelvis, Genital / Reproductive system female, Education and training, Peritoneum
Authors:
J. Salvador García, T. Ripollés-González, A. T. Vizarreta, R. Vila, J. J. Delgado Moraleda, M. J. Martinez; Valencia/ES
DOI:
10.1594/ecr2018/C-1464
Methods and materials
A retrospective study was performed (from 2009 to 2016),
which included 29 patients with echographic diagnosis of DIE.
The findings were confirmed by surgery,
histopathology and / or MRI.
The ultrasound findings assessed were the following:
- Endometriotic foci morphology: nodular,
laminar (plaque-like),
pseudonodular with tails at their ends.
- Margins: smooth,
microlobulated or spiculated.
- Echo pattern: hypoechoic,
hyperechoic or mixed content.
- Anatomic location: bowel endometriosis or anterior,
middle or posterior compartment of the pelvis. The contents of the anterior compartment of the pelvis include the urinary bladder,
ureters and urethra.
The middle compartment contains the female genital organs,
including the ovaries,
uterine tubes,
uterus,
and vagina.
The broad ligaments are peritoneal folds between the uterus and the lateral walls of the pelvis and are also a part of the rectouterine and vesicouterine folds. The contents of the posterior compartment of the pelvis include the rectovaginal septum (located between the posterior vaginal wall and the anterior rectal wall),
torus uterinus (small transverse thickening that binds the original insertion of the uterosacral ligaments behind the posterior cervix),
retrocervical area (virtual extraperitoneal space behind the cervix,
situated in the same plane as the rectovaginal pouch and above the rectovaginal septum) and rectovaginal pouch or pouch of Douglas.
We used a Toshiba Applio XG ultrasound (Toshiba,
Tohio,
Japan) with convex transducers of 3-6 MHz and 6-10 MH,
and endocavitary 6-8 Mhz.