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Sonographic evaluation of deep endometriosis: protocol for a US radiology practice

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Abstract

Endometriosis is a common condition with significant morbidity, including pain and subfertility, which is often subject to a delay in diagnosis. Ultrasound has been successfully utilized, mostly outside North America, to preoperatively stage deep endometriosis, but in these international settings, imaging is typically performed solely by expert radiologists and gynecologists. We outline a method for detailed sonographic survey of the lower abdomen and pelvis to ensure optimum detection and communication of disease extent that is geared to radiologists practicing ultrasound in the United States, with the use of diagnostic medical sonographers.

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Acknowledgments

The authors acknowledge Drs. Manoel Gonçalves, Mauricio Abrão and Leandro Accardo de Mattos at Clinica Medicina da Mulher in São Paolo, Brazil for their invaluable training.

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Authors and Affiliations

  1. Mayo Clinic Arizona, 5777 E. Mayo Blvd., Phoenix, AZ, 85054, USA

    Scott W. Young, Nicole B. Saphier, Nirvikar Dahiya, Christine O. Menias, Andrew A. Bridge, Christopher D. Czaplicki & Maitray D. Patel

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  1. Scott W. Young
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  2. Nicole B. Saphier
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Correspondence to Scott W. Young.

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The authors whose names are listed immediately below certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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This article is a review article which does not contain any studies with human participants or animals performed by any of the authors.

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261_2016_886_MOESM1_ESM.avi

Video 1: Uterine sliding sign, normal appearance. The transducer is seated in the anterior fornix, just in front of the anterior cervical lip, adjacent to the urinary bladder. Note the sharp, smooth interface between the posterior wall of the cervix and the bowel and retrocervical adipose deep to the cervix and uterine body. Free motion is evident during ballottement (AVI 9067 KB).

261_2016_886_MOESM2_ESM.avi

Video 2: Uterine sliding sign, abnormal appearance. Note the irregular, hypoechoic interface between the cervix and retrocervical/rectal endometriotic implant. Findings are consistent with posterior cul-de-sac obliteration “frozen pelvis” (AVI 9026 KB).

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Young, S.W., Saphier, N.B., Dahiya, N. et al. Sonographic evaluation of deep endometriosis: protocol for a US radiology practice. Abdom Radiol 41, 2364–2379 (2016). https://doi.org/10.1007/s00261-016-0886-5

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  • DOI: https://doi.org/10.1007/s00261-016-0886-5

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