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Congress: ECR25
Poster Number: C-19979
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-19979
Authorblock: R. P. Ribeiro, L. Romão, M. M. Carreiró, C. Antunes, A. Rodrigues; Coimbra/PT
Disclosures:
Raquel Pessoa Ribeiro: Nothing to disclose
Luís Romão: Nothing to disclose
Miguel Monteiro Carreiró: Nothing to disclose
Célia Antunes: Nothing to disclose
Angela Rodrigues: Nothing to disclose
Keywords: Genital / Reproductive system female, Ultrasound, Diagnostic procedure, Education and training
Learning objectives Endometriosis is a chronic inflammatory condition defined as the presence of endometrial-like tissue consisting of endometrial glands and stroma outside the uterus, affecting approximately 10% of reproductive-age women. There are three types of pelvic endometriosis: Superficial endometriosis - non-invasive superficial peritoneal nodules or plaques. Ovarian endometrioma Deep endometriosis (DE) - the most severe, caused by endometrial implants extending to any depth beneath the peritoneal surface. DE is considered a primary contributor to the symptoms associated with endometriosis. Routine pelvic ultrasound is often inadequate for detecting DE,...
Read more Background The Society of Radiologists in Ultrasound Consensus on Routine Pelvic US for Endometriosis describes this dedicated endometriosis ultrasound as a routine pelvic ultrasound complemented with evaluation of the relative positioning of the uterus and ovaries, longitudinal and transverse sweeps extending beyond the uterus and ovaries to evaluate the posterior and anterior compartments, and a dynamic assessment of organ mobility (uterine sliding sign) and specific sites and tenderness points.In pre-menopausal and early postmenopausal women (< 5 years since menopause) with positive...
Read more Findings and procedure details Ultrasound mapping of disease´s extent and location enables optimal planning of patient care, supports justification for non-surgical intervention and, when necessary, for the decision to refer patients to a tertiary laparoscopy center while discussing surgical risks and complications of surgery. Typical locations for DE implantsIn most patients, DE manifests in the posterior compartment, including the uterosacral ligaments (USL’s), rectum and rectosigmoid junction. [fig 1] Specific maneuvers for evaluation of DE implants  Evaluation of the retrocervical space During retrocervical area scanning, it is essential to evaluate...
Read more Conclusion Transvaginal ultrasonography is a very important and accessible tool for the diagnosis of endometriosis. It allows insights into the affected areas and the severity of the disease by focusing on the most commonly anatomical regions involved in DE in symptomatic patients. The Society of Radiologists in Ultrasound Consensus on Routine Pelvic US for Endometriosis, in its recommendations, advocates for a systematic and detailed ultrasound examination of the pelvis, including the structures described in the previous sector, categorizing them in 3 categories...
Read more References American College of Obstetricians and Gynecologists. (2010). Practice Bulletin No. 114: Management of endometriosis. Obstetrics & Gynecology, 116(1), 223–236. https://doi.org/10.1097/AOG.0b013e3181e9b0c8 European Society of Human Reproduction and Embryology (ESHRE). (2022). ESHRE guideline: Endometriosis. https://www.eshre.eu/Guideline/Endometriosis Hudelist, G., Fritzer, N., Staettner, S., Tammaa, A., Tinelli, A., Sparic, R., & Keckstein, J. (2013). Uterine sliding sign: A simple sonographic predictor for presence of deep infiltrating endometriosis of the rectum. Ultrasound in Obstetrics & Gynecology, 41(6), 692–695. https://doi.org/10.1002/uog.12431 International Deep Endometriosis Analysis (IDEA) Group. (2016). IDEA consensus for...
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