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Related Experiment Video

Updated: Dec 23, 2025

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity
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Diagnosing Deep Endometriosis Using Transvaginal Elastosonography.

Ding Ding1, Yishan Chen1, Xishi Liu2,3

  • 1Shanghai OB/GYN Hospital, Fudan University, Shanghai, 200090, China.

Reproductive Sciences (Thousand Oaks, Calif.)
|April 26, 2020
PubMed
Summary
This summary is machine-generated.

Transvaginal elastosonography (TVESG) detects all deep endometriosis (DE) cases, unlike other methods. Lesional stiffness measured by TVESG correlates with fibrosis and disease markers, improving DE diagnosis and treatment selection.

Keywords:
Deep endometriosisFibrosisProgesterone receptorStiffnessTransvaginal elastosonographyTransvaginal ultrasonographyVascularity

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Area of Science:

  • Gynecology and Obstetrics
  • Medical Imaging
  • Pathology

Background:

  • Deep endometriosis (DE) diagnosis relies on imaging techniques like transvaginal ultrasound (TVUS) and MRI, with room for diagnostic improvement.
  • Endometriotic lesions develop fibrosis and increased stiffness, making elastography a suitable method for DE assessment.

Purpose of the Study:

  • To evaluate if lesional stiffness measured by transvaginal elastosonography (TVESG) correlates with fibrosis, progression markers, hormonal receptor expression, and vascularity in DE.
  • To assess TVESG's diagnostic accuracy for DE compared to conventional methods.

Main Methods:

  • Thirty patients with suspected DE underwent pelvic examination, TVUS/MRI, and TVESG.
  • Histological diagnosis was confirmed, and lesional tissues were analyzed for fibrosis, epithelial-mesenchymal transition (EMT), fibroblast-to-myofibroblast transdifferentiation (FMT), estrogen and progesterone receptor (ERβ, PR) expression, and microvessel density (MVD).

Main Results:

  • TVESG detected 100% of DE cases, surpassing pelvic examination (83.3%), TVUS (66.7%), and MRI (83.3%).
  • Missed lesions by other methods were smaller but exhibited higher stiffness.
  • Lesional stiffness positively correlated with fibrosis and FMT marker, and negatively with EMT markers, MVD, vascularity, and PR expression, but positively with ERβ.

Conclusions:

  • TVESG enhances DE diagnostic accuracy by incorporating tissue stiffness information.
  • TVESG provides insights into lesion developmental stage, potentially guiding clinical treatment decisions.
  • Stiffness assessment via TVESG offers a valuable adjunct to conventional imaging for DE management.