Ultrasonography for bowel endometriosis
Simone Ferrero1, Fabio Barra1, Carolina Scala2
1Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy.
Transvaginal ultrasonography (TVS) is the primary imaging tool for suspected rectosigmoid endometriosis, offering high diagnostic accuracy. Enhanced TVS techniques do not improve performance but can assess infiltration depth and rectal stenosis.
Area of Science:
- Gynecology
- Diagnostic Imaging
Background:
- Deep endometriosis, particularly rectosigmoid involvement, requires accurate diagnosis.
- Transvaginal ultrasonography (TVS) is a key imaging modality for gynecological conditions.
Purpose of the Study:
- To evaluate the diagnostic performance of TVS for rectosigmoid endometriosis.
- To assess the utility of enhanced TVS techniques and compare TVS with MRI.
Main Methods:
- Review of ultrasonographic findings characteristic of rectosigmoid endometriosis.
- Analysis of the learning curve for TVS proficiency.
- Comparison of TVS with enhanced TVS and magnetic resonance imaging (MRI).
Main Results:
- TVS demonstrates high diagnostic performance for rectosigmoid endometriosis, with a short learning curve.
- Soft markers like negative sliding sign and kissing ovaries aid diagnosis.
- Enhanced TVS and MRI show comparable performance to standard TVS for rectosigmoid endometriosis.
Conclusions:
- TVS is the recommended first-line investigation for suspected rectosigmoid endometriosis.
- MRI serves as a second-line option for equivocal TVS findings.
- Enhanced TVS may provide additional information on infiltration depth and stenosis.
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