Ultrasound in Deep Endometriosis: A Narrative Review.

Area of Science:

• Gynecology
• Medical Imaging
• Reproductive Medicine

Background:

• Transvaginal ultrasound (TVUS) has significantly advanced deep endometriosis diagnosis over the last decade.
• Current evidence supports TVUS for accurate lesion evaluation in multiple pelvic compartments, reducing the need for initial laparoscopy.
• Research in deep endometriosis diagnostics has expanded, with new evidence supporting imaging techniques.

Purpose of the Study:

• To provide a comprehensive review of the current state of ultrasound diagnosis for deep endometriosis.
• To consolidate recent advancements and evidence in the field of deep endometriosis imaging.

Main Methods:

• A systematic literature search was conducted using PubMed.
• Included studies were English-language publications using "endometriosis," "deep," "ultrasound," and "transvaginal" search terms.
• Studies were selected based on title and abstract review, focusing on TVUS as a primary diagnostic technique.

Main Results:

• An initial search identified 243 studies.
• A total of 73 studies were included in the final review after applying selection criteria.

Conclusions:

• Deep endometriosis understanding has evolved, with TVUS emerging as a preferred first-line diagnostic modality.
• TVUS offers advantages in availability, performance, cost-effectiveness, and lower environmental impact compared to other imaging methods.
• Technological advancements facilitate earlier detection and improved management of deep endometriosis, addressing pelvic pain and infertility.