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DOI: 10.1055/s-0040-1718740
Transvaginal Sonographic Imaging and Associated Techniques for Diagnosis of Ovarian, Deep Endometriosis, and Adenomyosis: A Comprehensive Review
Funding The authors confirm that no funding was received for this review.![](https://www.thieme-connect.de/media/srm/20200203/lookinside/thumbnails/10-1055-s-0040-1718740_2000010-1.jpg)
Abstract
Imaging of endometriosis and in particular deep endometriosis (DE) is crucial in the clinical management of women facing this debilitating condition. Transvaginal sonography (TVS) is the first-line imaging method and magnetic resonance imaging (MRI) may provide supplemental information. However, the delay in diagnosis of up to 10 years and more is of concern. This problem might be overcome by simple steps using imaging with emphasis on TVS and referral to tertiary care. Finally, TVS is crucial in mapping extent and location of disease in planning surgical therapy and counseling women regarding various therapeutic options. This review presents the available data on imaging of endometriosis with a focus on TVS and MRI for DE, adenomyosis, and ovarian endometriomas including endometriomas in pregnancy as well as the use of “soft markers.” The review presents an approach that is in accordance with the International Deep Endometriosis Analysis (IDEA) group consensus statement.
Publication History
Article published online:
24 November 2020
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References
- 1 Hudelist G, Fritzer N, Thomas A. et al. Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod 2012; 27 (12) 3412-3416
- 2 Husby GK, Haugen RS, Moen MH. Diagnostic delay in women with pain and endometriosis. Acta Obstet Gynecol Scand 2003; 82 (07) 649-653
- 3 Nnoaham KE, Hummelshoj L, Webster P. et al; World Endometriosis Research Foundation Global Study of Women's Health consortium. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril 2011; 96 (02) 366-373.e8
- 4 Ballard K, Lowton K, Wright J. What's the delay? A qualitative study of women's experiences of reaching a diagnosis of endometriosis. Fertil Steril 2006; 86 (05) 1296-1301
- 5 Wykes CB, Clark TJ, Khan KS. Accuracy of laparoscopy in the diagnosis of endometriosis: a systematic quantitative review. BJOG 2004; 111 (11) 1204-1212
- 6 Bendifallah S, Roman H, Rubod C. et al. Impact of hospital and surgeon case volume on morbidity in colorectal endometriosis management: a plea to define criteria for expert centers. Surg Endosc 2018; 32 (04) 2003-2011
- 7 Nisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril 1997; 68 (04) 585-596
- 8 Guerriero S, Ajossa S, Minguez JA. et al. Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in uterosacral ligaments, rectovaginal septum, vagina and bladder: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2015; 46 (05) 534-545
- 9 Guerriero S, Condous G, van den Bosch T. et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol 2016; 48 (03) 318-332
- 10 Hudelist G, Aas-Eng MK, Birsan T. et al. Pain and fertility outcomes of nerve-sparing, full-thickness disk or segmental bowel resection for deep infiltrating endometriosis - a prospective cohort study. Acta Obstet Gynecol Scand 2018; 97 (12) 1438-1446
- 11 Hudelist G, Tammaa A, Aas-Eng MK. et al. Outcome of sonography-based minimally invasive surgery for deep infiltrating endometriosis of the ureter and urinary bladder - a retrospective cohort study. Acta Obstet Gynecol Scand 2018; 97 (03) 277-284
- 12 Vilasagar S, Bougie O, Singh SS. A practical guide to the clinical evaluation of endometriosis-associated pelvic pain. J Minim Invasive Gynecol 2020; 27 (02) 270-279
- 13 Vercellini P, Fedele L, Aimi G, Pietropaolo G, Consonni D, Crosignani PG. Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients. Hum Reprod 2007; 22 (01) 266-271
- 14 Vercellini P, Trespidi L, De Giorgi O, Cortesi I, Parazzini F, Crosignani PG. Endometriosis and pelvic pain: relation to disease stage and localization. Fertil Steril 1996; 65 (02) 299-304
- 15 Montanari E, Dauser B, Keckstein J, Kirchner E, Nemeth Z, Hudelist G. Association between disease extent and pain symptoms in patients with deep infiltrating endometriosis. Reprod Biomed Online 2019; 39 (05) 845-851
- 16 Haas D, Shebl O, Shamiyeh A, Oppelt P. The rASRM score and the Enzian classification for endometriosis: their strengths and weaknesses. Acta Obstet Gynecol Scand 2013; 92 (01) 3-7
- 17 Hudelist G, Oberwinkler KH, Singer CF. et al. Combination of transvaginal sonography and clinical examination for preoperative diagnosis of pelvic endometriosis. Hum Reprod 2009; 24 (05) 1018-1024
- 18 Bazot M, Lafont C, Rouzier R, Roseau G, Thomassin-Naggara I, Daraï E. Diagnostic accuracy of physical examination, transvaginal sonography, rectal endoscopic sonography, and magnetic resonance imaging to diagnose deep infiltrating endometriosis. Fertil Steril 2009; 92 (06) 1825-1833
- 19 Hudelist G, Ballard K, English J. et al. Transvaginal sonography vs. clinical examination in the preoperative diagnosis of deep infiltrating endometriosis. Ultrasound Obstet Gynecol 2011; 37 (04) 480-487
- 20 Abrao MS, Gonçalves MO, Dias Jr JA, Podgaec S, Chamie LP, Blasbalg R. Comparison between clinical examination, transvaginal sonography and magnetic resonance imaging for the diagnosis of deep endometriosis. Hum Reprod 2007; 22 (12) 3092-3097
- 21 Hudelist G, English J, Thomas AE, Tinelli A, Singer CF, Keckstein J. Diagnostic accuracy of transvaginal ultrasound for non-invasive diagnosis of bowel endometriosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2011; 37 (03) 257-263
- 22 Bazot M, Thomassin I, Hourani R, Cortez A, Darai E. Diagnostic accuracy of transvaginal sonography for deep pelvic endometriosis. Ultrasound Obstet Gynecol 2004; 24 (02) 180-185
- 23 Piketty M, Chopin N, Dousset B. et al. Preoperative work-up for patients with deeply infiltrating endometriosis: transvaginal ultrasonography must definitely be the first-line imaging examination. Hum Reprod 2009; 24 (03) 602-607
- 24 Chapron C, Chopin N, Borghese B. et al. Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution. Hum Reprod 2006; 21 (07) 1839-1845
- 25 Chapron C, Vercellini P, Barakat H, Vieira M, Dubuisson JB. Management of ovarian endometriomas. Hum Reprod Update 2002; 8 (06) 591-597
- 26 Kavoussi SK, Odenwald KC, As-Sanie S, Lebovic DI. Incidence of ovarian endometrioma among women with peritoneal endometriosis with and without a history of hormonal contraceptive use. Eur J Obstet Gynecol Reprod Biol 2017; 215: 220-223
- 27 Van Holsbeke C, Van Calster B, Guerriero S. et al. Endometriomas: their ultrasound characteristics. Ultrasound Obstet Gynecol 2010; 35 (06) 730-740
- 28 Sayasneh A, Ekechi C, Ferrara L. et al. The characteristic ultrasound features of specific types of ovarian pathology. (review). Int J Oncol 2015; 46 (02) 445-458
- 29 Chapron C, Pietin-Vialle C, Borghese B, Davy C, Foulot H, Chopin N. Associated ovarian endometrioma is a marker for greater severity of deeply infiltrating endometriosis. Fertil Steril 2009; 92 (02) 453-457
- 30 Banerjee SK, Ballard KD, Wright JT. Endometriomas as a marker of disease severity. J Minim Invasive Gynecol 2008; 15 (05) 538-540
- 31 Somigliana E, Infantino M, Candiani M. et al. Association rate between deep peritoneal endometriosis and other forms of the disease: pathogenetic implications. Hum Reprod 2004; 19 (01) 168-171
- 32 Chapron C, Santulli P, de Ziegler D. et al. Ovarian endometrioma: severe pelvic pain is associated with deeply infiltrating endometriosis. Hum Reprod 2012; 27 (03) 702-711
- 33 Ghezzi F, Raio L, Cromi A. et al. “Kissing ovaries”: a sonographic sign of moderate to severe endometriosis. Fertil Steril 2005; 83 (01) 143-147
- 34 Leonardi M, Reid S, Lu C, Condous G. Prevalence of deep endometriosis and rectouterine pouch obliteration in the presence of normal ovaries. J Obstet Gynaecol Can 2020; S1701-2163(20)30340-6
- 35 Kim HS, Kim TH, Chung HH, Song YS. Risk and prognosis of ovarian cancer in women with endometriosis: a meta-analysis. Br J Cancer 2014; 110 (07) 1878-1890
- 36 Kvaskoff M, Horne AW, Missmer SA. Informing women with endometriosis about ovarian cancer risk. Lancet 2017; 390 (10111): 2433-2434
- 37 Guerriero S, Van Calster B, Somigliana E. et al. Age-related differences in the sonographic characteristics of endometriomas. Hum Reprod 2016; 31 (08) 1723-1731
- 38 Testa AC, Timmerman D, Van Holsbeke C. et al. Ovarian cancer arising in endometrioid cysts: ultrasound findings. Ultrasound Obstet Gynecol 2011; 38 (01) 99-106
- 39 Timmerman D, Van Calster B, Testa A. et al. Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumor Analysis group. Am J Obstet Gynecol 2016; 214 (04) 424-437
- 40 Van Calster B, Van Hoorde K, Valentin L. et al; International Ovarian Tumour Analysis Group. Evaluating the risk of ovarian cancer before surgery using the ADNEX model to differentiate between benign, borderline, early and advanced stage invasive, and secondary metastatic tumours: prospective multicentre diagnostic study. BMJ 2014; 349: g5920
- 41 Pateman K, Moro F, Mavrelos D, Foo X, Hoo WL, Jurkovic D. Natural history of ovarian endometrioma in pregnancy. BMC Womens Health 2014; 14: 128
- 42 Mascilini F, Moruzzi C, Giansiracusa C. et al. Imaging in gynecological disease. 10: Clinical and ultrasound characteristics of decidualized endometriomas surgically removed during pregnancy. Ultrasound Obstet Gynecol 2014; 44 (03) 354-360
- 43 Fruscella E, Testa AC, Ferrandina G. et al. Sonographic features of decidualized ovarian endometriosis suspicious for malignancy. Ultrasound Obstet Gynecol 2004; 24 (05) 578-580
- 44 Bailleux M, Bernard JP, Benachi A, Deffieux X. Ovarian endometriosis during pregnancy: a series of 53 endometriomas. Eur J Obstet Gynecol Reprod Biol 2017; 209: 100-104
- 45 Barbieri M, Somigliana E, Oneda S, Ossola MW, Acaia B, Fedele L. Decidualized ovarian endometriosis in pregnancy: a challenging diagnostic entity. Hum Reprod 2009; 24 (08) 1818-1824
- 46 Aggarwal P, Kehoe S. Ovarian tumours in pregnancy: a literature review. Eur J Obstet Gynecol Reprod Biol 2011; 155 (02) 119-124
- 47 Espada M, Leonardi M, Aas-Eng K. et al. A multi-center international temporal and external validation study of the ultrasound-based endometriosis staging system (UBESS). J Minim Invasive Gynecol 2020; S1553-4650(20)30184-9
- 48 Guerriero S, Ajossa S, Lai MP, Mais V, Paoletti AM, Melis GB. Transvaginal ultrasonography in the diagnosis of pelvic adhesions. Hum Reprod 1997; 12 (12) 2649-2653
- 49 Guerriero S, Ajossa S, Garau N, Alcazar JL, Mais V, Melis GB. Diagnosis of pelvic adhesions in patients with endometrioma: the role of transvaginal ultrasonography. Fertil Steril 2010; 94 (02) 742-746
- 50 Okaro E, Condous G, Khalid A. et al. The use of ultrasound-based ‘soft markers’ for the prediction of pelvic pathology in women with chronic pelvic pain--can we reduce the need for laparoscopy?. BJOG 2006; 113 (03) 251-256
- 51 Gerges B, Lu C, Reid S, Chou D, Chang T, Condous G. Sonographic evaluation of immobility of normal and endometriotic ovary in detection of deep endometriosis. Ultrasound Obstet Gynecol 2017; 49 (06) 793-798
- 52 Habiba M, Gordts S, Bazot M, Brosens I, Benagiano G. Exploring the challenges for a new classification of adenomyosis. Reprod Biomed Online 2020; 40 (04) 569-581
- 53 Koninckx PR, Ussia A, Adamyan L, Wattiez A, Donnez J. Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril 2012; 98 (03) 564-571
- 54 Hudelist G, Fritzer N, Staettner S. et al. Uterine sliding sign: a simple sonographic predictor for presence of deep infiltrating endometriosis of the rectum. Ultrasound Obstet Gynecol 2013; 41 (06) 692-695
- 55 Reid S, Condous G. Transvaginal sonographic sliding sign: accurate prediction of pouch of Douglas obliteration. Ultrasound Obstet Gynecol 2013; 41 (06) 605-607
- 56 Tammaa A, Fritzer N, Strunk G, Krell A, Salzer H, Hudelist G. Learning curve for the detection of pouch of Douglas obliteration and deep infiltrating endometriosis of the rectum. Hum Reprod 2014; 29 (06) 1199-1204
- 57 Reid S, Lu C, Casikar I. et al. The prediction of pouch of Douglas obliteration using offline analysis of the transvaginal ultrasound ‘sliding sign’ technique: inter- and intra-observer reproducibility. Hum Reprod 2013; 28 (05) 1237-1246
- 58 Berlanda N, Vercellini P, Carmignani L, Aimi G, Amicarelli F, Fedele L. Ureteral and vesical endometriosis. Two different clinical entities sharing the same pathogenesis. Obstet Gynecol Surv 2009; 64 (12) 830-842
- 59 Knabben L, Imboden S, Fellmann B, Nirgianakis K, Kuhn A, Mueller MD. Urinary tract endometriosis in patients with deep infiltrating endometriosis: prevalence, symptoms, management, and proposal for a new clinical classification. Fertil Steril 2015; 103 (01) 147-152
- 60 Barra F, Scala C, Biscaldi E. et al. Ureteral endometriosis: a systematic review of epidemiology, pathogenesis, diagnosis, treatment, risk of malignant transformation and fertility. Hum Reprod Update 2018; 24 (06) 710-730
- 61 Langebrekke A, Qvigstad E. Ureteral endometriosis and loss of renal function: mechanisms and interpretations. Acta Obstet Gynecol Scand 2011; 90 (10) 1164-1166
- 62 Maccagnano C, Pellucchi F, Rocchini L. et al. Diagnosis and treatment of bladder endometriosis: state of the art. Urol Int 2012; 89 (03) 249-258
- 63 Savelli L, Manuzzi L, Pollastri P, Mabrouk M, Seracchioli R, Venturoli S. Diagnostic accuracy and potential limitations of transvaginal sonography for bladder endometriosis. Ultrasound Obstet Gynecol 2009; 34 (05) 595-600
- 64 Villa G, Mabrouk M, Guerrini M. et al. Relationship between site and size of bladder endometriotic nodules and severity of dysuria. J Minim Invasive Gynecol 2007; 14 (05) 628-632
- 65 Chapron C, Chiodo I, Leconte M. et al. Severe ureteral endometriosis: the intrinsic type is not so rare after complete surgical exeresis of deep endometriotic lesions. Fertil Steril 2010; 93 (07) 2115-2120
- 66 Cavaco-Gomes J, Martinho M, Gilabert-Aguilar J, Gilabert-Estélles J. Laparoscopic management of ureteral endometriosis: a systematic review. Eur J Obstet Gynecol Reprod Biol 2017; 210: 94-101
- 67 Vercellini P, Pisacreta A, Pesole A, Vicentini S, Stellato G, Crosignani PG. Is ureteral endometriosis an asymmetric disease?. BJOG 2000; 107 (04) 559-561
- 68 Abrao MS, Dias Jr JA, Bellelis P, Podgaec S, Bautzer CR, Gromatsky C. Endometriosis of the ureter and bladder are not associated diseases. Fertil Steril 2009; 91 (05) 1662-1667
- 69 Kondo W, Branco AW, Trippia CH, Ribeiro R, Zomer MT. Retrocervical deep infiltrating endometriotic lesions larger than thirty millimeters are associated with an increased rate of ureteral involvement. J Minim Invasive Gynecol 2013; 20 (01) 100-103
- 70 Donnez J, Nisolle M, Squifflet J. Ureteral endometriosis: a complication of rectovaginal endometriotic (adenomyotic) nodules. Fertil Steril 2002; 77 (01) 32-37
- 71 Pateman K, Holland TK, Knez J. et al. Should a detailed ultrasound examination of the complete urinary tract be routinely performed in women with suspected pelvic endometriosis?. Hum Reprod 2015; 30 (12) 2802-2807
- 72 Carfagna P, De Cicco Nardone C, De Cicco Nardone A. et al. Role of transvaginal ultrasound in evaluation of ureteral involvement in deep infiltrating endometriosis. Ultrasound Obstet Gynecol 2018; 51 (04) 550-555
- 73 Pateman K, Mavrelos D, Hoo WL, Holland T, Naftalin J, Jurkovic D. Visualization of ureters on standard gynecological transvaginal scan: a feasibility study. Ultrasound Obstet Gynecol 2013; 41 (06) 696-701
- 74 Bean E, Naftalin J, Jurkovic D. How to assess the ureters during pelvic ultrasound. Ultrasound Obstet Gynecol 2019; 53 (06) 729-733
- 75 Aas-Eng K, Salama M, Sevelda U, Ruesch C, Nemeth Z, Hudelist G. Learning curve for detection of the distal part of ureters by transvaginal sonography (TVS): a feasibility study. Ultrasound Obstet Gynecol 2020; 55: 264-268
- 76 Ong J, Leonardi M, Espada M, Stamatopoulos N, Georgousopoulou E, Condous G. Ureter visualization with transvaginal ultrasound. J Ultrasound Med 2020; 9999: 1-8
- 77 Lima R, Abdalla-Ribeiro H, Nicola AL, Eras A, Lobao A, Ribeiro PA. Endometriosis on the uterosacral ligament: a marker of ureteral involvement. Fertil Steril 2017; 107 (06) 1348-1354
- 78 Leonardi M, Condous G. A pictorial guide to the ultrasound identification and assessment of uterosacral ligaments in women with potential endometriosis. Australas J Ultrasound Med 2019; 22 (03) 157-164
- 79 Leonardi M, Martins WP, Espada M, Arianayagam M, Condous G. Proposed technique to visualize and classify uterosacral ligament deep endometriosis with and without infiltration into parametrium or torus uterinus. Ultrasound Obstet Gynecol 2020; 55 (01) 137-139
- 80 Guerriero S, Ajossa S, Gerada M, Virgilio B, Angioni S, Melis GB. Diagnostic value of transvaginal ‘tenderness-guided’ ultrasonography for the prediction of location of deep endometriosis. Hum Reprod 2008; 23 (11) 2452-2457
- 81 Exacoustos C, Malzoni M, Di Giovanni A. et al. Ultrasound mapping system for the surgical management of deep infiltrating endometriosis. Fertil Steril 2014; 102 (01) 143-150.e2
- 82 Martin DC, Batt RE. Retrocervical, retrovaginal pouch, and rectovaginal septum endometriosis. J Am Assoc Gynecol Laparosc 2001; 8 (01) 12-17
- 83 Aas-Eng MK, Dauser B, Lieng M. et al. Transvaginal sonography accurately predicts lesion to anal verge distance in women with deep endometriosis of the rectosigmoid. Ultrasound Obstet Gynecol 2020; DOI: doi.org/10.1002/uog.21995.
- 84 Kavallaris A, Köhler C, Kühne-Heid R, Schneider A. Histopathological extent of rectal invasion by rectovaginal endometriosis. Hum Reprod 2003; 18 (06) 1323-1327
- 85 Keckstein J, Becker CM, Canis M. et al. Recommendations for the surgical treatment of endometriosis. Part 2: deep endometriosis. Human Reproduct Open 2020; 2020 (01) hoaa002
- 86 Guerriero S, Saba L, Pascual MA. et al. Transvaginal ultrasound vs magnetic resonance imaging for diagnosing deep infiltrating endometriosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2018; 51 (05) 586-595
- 87 Guerriero S, Ajossa S, Gerada M, D'Aquila M, Piras B, Melis GB. “Tenderness-guided” transvaginal ultrasonography: a new method for the detection of deep endometriosis in patients with chronic pelvic pain. Fertil Steril 2007; 88 (05) 1293-1297
- 88 Hudelist G, Aas-Eng K. Rectovaginal septum endometriosis. In: Guerriero S, Condous G, Alcázar JL. eds. How to Perform Ultrasonography in Endometriosis. Cham, Switzerland: Springer International Publishing; 2018: 97-102
- 89 Hudelist G, Tuttlies F, Rauter G, Pucher S, Keckstein J. Can transvaginal sonography predict infiltration depth in patients with deep infiltrating endometriosis of the rectum?. Hum Reprod 2009; 24 (05) 1012-1017
- 90 Reid S, Espada M, Lu C, Condous G. To determine the optimal ultrasonographic screening method for rectal/rectosigmoid deep endometriosis: ultrasound “sliding sign,” transvaginal ultrasound direct visualization or both?. Acta Obstet Gynecol Scand 2018; 97 (11) 1287-1292
- 91 Netter A, d'Avout-Fourdinier P, Agostini A. et al. Progression of deep infiltrating rectosigmoid endometriotic nodules. Hum Reprod 2019; 34 (11) 2144-2152
- 92 Egekvist AG, Marinovskij E, Forman A, Kesmodel US, Graumann O, Seyer-Hansen M. Conservative treatment of rectosigmoid endometriosis: a prospective study. Acta Obstet Gynecol Scand 2019; 98 (09) 1139-1147
- 93 Rullier E, Laurent C, Garrelon JL, Michel P, Saric J, Parneix M. Risk factors for anastomotic leakage after resection of rectal cancer. Br J Surg 1998; 85 (03) 355-358
- 94 Matthiessen P, Hallböök O, Andersson M, Rutegård J, Sjödahl R. Risk factors for anastomotic leakage after anterior resection of the rectum. Colorectal Dis 2004; 6 (06) 462-469
- 95 Boyce SA, Harris C, Stevenson A, Lumley J, Clark D. Management of low colorectal anastomotic leakage in the laparoscopic era: more than a decade of experience. Dis Colon Rectum 2017; 60 (08) 807-814
- 96 Malzoni M, Casarella L, Coppola M. et al. Preoperative ultrasound indications determine excision technique for bowel surgery for deep infiltrating endometriosis: a single, high-volume center. J Minim Invasive Gynecol 2020; 27 (05) 1141-1147
- 97 Vanhie A, Meuleman C, Tomassetti C. et al. Consensus on recording deep endometriosis surgery: the CORDES statement. Hum Reprod 2016; 31 (06) 1219-1223
- 98 Abrão MS, Petraglia F, Falcone T, Keckstein J, Osuga Y, Chapron C. Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management. Hum Reprod Update 2015; 21 (03) 329-339
- 99 Di Giovanni A, Casarella L, Coppola M, Iuzzolino D, Rasile M, Malzoni M. Combined transvaginal/transabdominal pelvic ultrasonography accurately predicts the 3 dimensions of deep infiltrating bowel endometriosis measured after surgery: a prospective study in a specialized center. J Minim Invasive Gynecol 2018; 25 (07) 1231-1240
- 100 Goncalves MO, Podgaec S, Dias Jr JA, Gonzalez M, Abrao MS. Transvaginal ultrasonography with bowel preparation is able to predict the number of lesions and rectosigmoid layers affected in cases of deep endometriosis, defining surgical strategy. Hum Reprod 2010; 25 (03) 665-671
- 101 Ros C, Rius M, Abrao MS. et al. Bowel preparation prior to transvaginal ultrasound improves the detection and visualization of rectosigmoid deep infiltrating endometriosis. A prospective study among women with suspected endometriosis without surgical criteria. Ultrasound Obstet Gynecol 2020
- 102 Ferrero S, Scala C, Stabilini C, Vellone VG, Barra F, Leone Roberti Maggiore U. Transvaginal sonography with vs without bowel preparation in diagnosis of rectosigmoid endometriosis: prospective study. Ultrasound Obstet Gynecol 2019; 53 (03) 402-409
- 103 Donnez O, Roman H. Choosing the right surgical technique for deep endometriosis: shaving, disc excision, or bowel resection?. Fertil Steril 2017; 108 (06) 931-942
- 104 Leyendecker G, Wildt L, Mall G. The pathophysiology of endometriosis and adenomyosis: tissue injury and repair. Arch Gynecol Obstet 2009; 280 (04) 529-538
- 105 García-Solares J, Donnez J, Donnez O, Dolmans MM. Pathogenesis of uterine adenomyosis: invagination or metaplasia?. Fertil Steril 2018; 109 (03) 371-379
- 106 Leyendecker G, Bilgicyildirim A, Inacker M. et al. Adenomyosis and endometriosis. Re-visiting their association and further insights into the mechanisms of auto-traumatisation. An MRI study. Arch Gynecol Obstet 2015; 291 (04) 917-932
- 107 Naftalin J, Hoo W, Pateman K, Mavrelos D, Holland T, Jurkovic D. How common is adenomyosis? A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic. Hum Reprod 2012; 27 (12) 3432-3439
- 108 Andres MP, Borrelli GM, Ribeiro J, Baracat EC, Abrão MS, Kho RM. Transvaginal ultrasound for the diagnosis of adenomyosis: systematic review and meta-analysis. J Minim Invasive Gynecol 2018; 25 (02) 257-264
- 109 Tellum T, Nygaard S, Lieng M. Noninvasive diagnosis of adenomyosis: a structured review and meta-analysis of diagnostic accuracy in imaging. J Minim Invasive Gynecol 2020; 27 (02) 408-418.e3
- 110 Van den Bosch T, Dueholm M, Leone FP. et al. Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group. Ultrasound Obstet Gynecol 2015; 46 (03) 284-298
- 111 Tellum T, Nygaard S, Skovholt EK, Qvigstad E, Lieng M. Development of a clinical prediction model for diagnosing adenomyosis. Fertil Steril 2018; 110 (05) 957-964.e3
- 112 Van den Bosch T, de Bruijn AM, de Leeuw RA. et al. Sonographic classification and reporting system for diagnosing adenomyosis. Ultrasound Obstet Gynecol 2019; 53 (05) 576-582
- 113 Exacoustos C, Morosetti G, Conway F. et al. New sonographic classification of adenomyosis: Do type and degree of adenomyosis correlate to severity of symptoms?. J Minim Invasive Gynecol 2019; 27 (06) 1308-1315
- 114 Bazot M, Bharwani N, Huchon C. et al. European Society of Urogenital Radiology (ESUR) guidelines: MR imaging of pelvic endometriosis. Eur Radiol 2017; 27 (07) 2765-2775
- 115 Zhang X, Li M, Guan J. et al. Evaluation of the sacral nerve plexus in pelvic endometriosis by three-dimensional MR neurography. J Magn Reson Imaging 2017; 45 (04) 1225-1231
- 116 Jha P, Sakala M, Chamie LP. et al. Endometriosis MRI lexicon: consensus statement from the society of abdominal radiology endometriosis disease-focused panel. Abdom Radiol (NY) 2020; 45 (06) 1552-1568
- 117 Tong A, VanBuren WM, Chamié L. et al. Recommendations for MRI technique in the evaluation of pelvic endometriosis: consensus statement from the Society of Abdominal Radiology endometriosis disease-focused panel. Abdom Radiol (NY) 2020; 45 (06) 1569-1586
- 118 Nisenblat V, Bossuyt PM, Farquhar C, Johnson N, Hull ML. Imaging modalities for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev 2016; 2: CD009591
- 119 Medeiros LR, Rosa MI, Silva BR. et al. Accuracy of magnetic resonance in deeply infiltrating endometriosis: a systematic review and meta-analysis. Arch Gynecol Obstet 2015; 291 (03) 611-621
- 120 The American Fertility Society. Classification of endometriosis. Fertil Steril 1979; 32 (06) 633-634
- 121 Revised American Fertility Society classification of endometriosis: 1985. Fertil Steril 1985; 43 (03) 351-352
- 122 Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril 1997; 67 (05) 817-821
- 123 Tuttlies F, Keckstein J, Ulrich U. et al. [ENZIAN-score, a classification of deep infiltrating endometriosis]. Zentralbl Gynäkol 2005; 127 (05) 275-281
- 124 Leonardi M, Espada M, Choi S. et al. Transvaginal ultrasound can accurately predict the American Society of Reproductive Medicine Stage of Endometriosis Assigned at Laparoscopy. J Minim Invasive Gynecol 2020; S1553-4650(20)30117-5
- 125 Keckstein J. A comprehensive non-invasive and surgical staging system for endometriosis: the #Enzian classification. Oral presentation at the Fifth European Congress on Endometriosis (EEC), Prague, Czech Republic; 2019