Previous

CURRENT ISSUE

№3' 2020

RADIATION DIAGNOSIS

International Medical Journal, Vol. 26., Iss. 3, 2020, P. 87−92.


DOI (https://doi.org/10.37436/2308-5274-2020-3-17)

MODERN ASPECTS OF ULTRASOUND DIAGNOSIS OF ENDOMETRIOID HETEROTOPIAS OF PELVIC CAVITY ORGANS


Novikova A. S., Kuzmina I. Yu.

Kharkiv National Medical University, Ukraine
Maria Medical Center, Kharkiv, Ukraine

Diagnosis of endometrioid heterotopias of the pelvic cavity is often complicated, because at the initial stage there are no characteristic sonographic signs of this pathology. However, transvaginal ultrasound can be used as the main imaging method in the patients with suspected endometriosis. Due to a wide variety of forms and degrees of endometriosis, the similarity of clinical signs of other diseases, frequent asymptomatic course of the disease are objective difficulties in the correct and timely diagnosis of endometrioid heterotopias of the pelvic cavity. Ultrasonography can be used both to detect and to monitor the dynamics of endometriosis. Transvaginal sonography allows a qualitative detection of endometrioid heterotopias of the pelvis and with a high probability to reveal endometrioid cysts, hydrosalpinx, hematosalpinx, peritoneal endometriosis and is considered the best method of visualization of the endometrium. There were examined 57 patients with various forms of endometrioid heterotopias of the pelvic organs by transvaginal ultrasonography, which was performed on the 5th−9th day of the menstrual cycle. Adenomyosis of various degrees has been diagnosed, which should be understood as a disease consisting of ectopic location of endometrial glands and stroma as well as muscle changes. Due to the variety of forms and degrees of endometriosis, combination with clinical signs of other diseases, often asymptomatic course of the disease, which leads to severe damage to the reproductive system, there are objective difficulties in correct and timely diagnosis of endometrioid heterotopias and pelvic cavity organs. Modern visual methods of transvaginal ultrasonography are the key to correctly determining the stage and extent of endometriosis, which will directly affect the choice of treatment.

Key words: endometriosis, heterotopia, ultrasound diagnostics, pelvic cavity.


REFERENCES


1. Harada T. Endometriosis Pathogenesis and Treatment // Springer. Japan, 2014. P. 3.

2. Linde V. A., Tatarova N. A. Endometriozy. Patogenez, klinicheskaya kartina, diagnostika i lechenie. M.: GEOTAR−Media, 2010. C. 192.

3. Cullen T. S. The distribution of adenomyomata containing uterine mucosa // Arch. Surg. 1921. Vol. 1. P. 215−283.

4. Sampson J. A. Peritoneal endometriosis due to the menstrual dissemination of endometrial tissue into the peritoneal cavity // Am. J. Obstet. Gynecol. 1927. Vol. 14. P. 422−469. doi: https://doi.org/10.1016/s0002−9378(15)30003−x

5. Pathogenesis of endometriosis: the genetic/epigenetic theory / P. R. Koninckx et al. // Fertility and Sterility. 2019. Vol. 111, № 2. P. 327−340. doi: https://doi.org/10.1016/j.fertnstert.2018.10.013

6. Schrager S., Falleroni J., Edgoose J. Evaluation and Treatment of Endometriosis // Am. Family Physicians. 2013. Vol. 87, №2. P. 108.

7. Parasar P., Ozcan P., Terry K. L. Endometriosis: Epidemiology, Diagnosis and Clinical Management // Curr. Obstet. Gynecol. Rep. 2017. Vol. 6, № 1. P. 34−41. doi: https://doi.org/10.1007/s13669−017−0187−1

8. Endometriosis: a critical appraisal of the advances and the controversies of a challenging health problem / M. A. Bedaiwy et al. // Minerva Ginecol. 2009. Vol. 61, № 4. P. 285−298.

9. Giudice L. C., Kao L. C. Endometriosis // Lancet. 2004. Vol. 364, № 9447. P. 1789−1799. doi: https://doi.org/10.1016/s0140−6736(04)17403−5

10. Deep Dyspareunia and Sexual Quality of Life in Women with Endometriosis / L. K. Shum et al. // Sexual Medicine. 2018. Vol. 6, № 3. P. 224−233.

11. Coxon L., Horne A. W., Vincent K. Pathophysiology of endometriosis−associated pain: a review of pelvic and central nervous system mechanisms // Best Pract. Res. Clin. Obstet. Gynaecol. 2018. Vol. 51. P. 53−67. doi: https://doi.org/10.1016/j.bpobgyn.2018.01.014

12. Hassa H., Tanir H. M., Uray M. Symptom distribution among infertile and fertile endometriosis cases with different stages and localizations // Eur. J. Obstet. Gynecol. Reprod. Biol. 2005. Vol. 119. P. 82−86. doi: https://doi.org/10.1016/j.ejogrb.2004.07.025

13. Increased pressure pain sensitivity in women with chronic pelvic pain / S. As−Sanie et al. // Obstet. Gynecol. 2013. Vol. 122. P. 1047−1055. doi: https://doi.org/10.1097/aog.0b013e3182a7e1f5

14. Reducing low−value care in endometriosis between limited evidence and unresolved issues: a proposal / P. Vercellini et al. // Human Reproduction. 2015. Vol. 30, № 9. P. 1996−2004. doi: https://doi.org/10.1093/humrep/dev157

15. Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients / L. Vercellini et al. // Human Reproduction. 2007. Vol. 22, № 1. P. 266−271. doi: https://doi.org/10.1093/humrep/del339

16. Timmerman D., Deprest J., Bourne T. Ultrasound and Endoscopic Surgery in Obstetrics and Gynaecology. A Combined Approach to Diagnosis and Treatment // Springer−Verlag London Limited. 2003. P. 183. doi: https://doi.org/10.1007/978−1−4471−0655−5

17. Preoperative work−up for patients with deeply infiltrating endometriosis: transvaginal ultrasonography must definitely be the first−line imaging examination / M. Piketty et al. // Human Reproduction. 2009. Vol. 24. P. 602−607. doi: https://doi.org/10.1093/humrep/den405

18. Jayaprakasan K., Becker C., Mittal M. The Effect of Surgery for Endometriomas on Fertility // BJOG. 2018. Vol. 55, № 125. P. 19−28.

19. Practice bulletin no. 114: management of endometriosis // Obstet. Gynecol. 2010. Vol. 116, № 1. P. 223−236.

20. European Practice in Gynaecology and Obstetrics. Ultrasound in Obstetrics and Gynaecology / Edited by Wladimiroff and Sturla Eik−Nes // Elsevier. 2009. P. 319. doi: https://doi.org/10.1016/b978−0−444−51829−3.00025−8

21. Jermy K., Luise C., Bourne T. The characterization of common ovarian cysts in premenopausal women // Ultrasound Obstet. Gynecol. 2001. Vol. 17. P. 140−144. doi: https://doi.org/10.1046/j.1469−0705.2001.00330.x

22. Associated ovarian endometrioma is a marker for greater severity of deeply infiltrating endometriosis / C. Chapron et al. // Fertil. Steril. 2009. Vol. 92. P. 453−457. doi: https://doi.org/10.1016/j.fertnstert.2008.06.003

23. "Kissing ovaries": a sonographic sign of moderate to severe endometriosis / F. Ghezzi et al. // Fertil. Steril. 2005. Vol. 83. P. 143−147. doi: https://doi.org/10.1016/j.fertnstert.2004.05.094

24. Magnetic Resonance Imaging (MRI) and Transvaginal Ultrasonography (TVU) at Ovarian Pain Caused by Benign Ovarian Lesions / A. Sofic et al. // Acta Inform. Med. 2018. Vol. 26, № 1. P. 15−18. doi: https://doi.org/10.5455/aim.2018.26.15−18

25. Woodward P. J., Sohaey R., Mezzetti T. P. Endometriosis: radiologicpathologic correlation // J. Radiographics. 2001. Vol. 21, № 1. P. 193−216. doi: https://doi.org/10.1148/radiographics.21.1.g01ja14193

26. Giudice L. C., Evers J. L. H., Healy D. L. Endometriosis: science and practice. Oxford: Wiley−Blackwell, 2012. 600 p.

27. Guerriero S. 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 // J. Ultrasound Obstet. Gynecol. 2016. Vol. 48. P. 318−332.

28. Transvaginal sonography vs clinical examination in the preoperative diagnosis of deep infiltrating endometriosis / G. Hudelist et al. // J. Ultrasound Obstet. Gynecol. 2011. Vol. 37. P. 480−487. doi: https://doi.org/10.1002/uog.8935

29. Diagnostic accuracy of physical examination, transvaginal sonography, rectal endoscopic sonography, and magnetic resonance imaging to diagnose deep infiltrating endometriosis / M. Bazot et al. // Fertil. Steril. 2009. Vol. 92. P. 1825−1833. doi: https://doi.org/10.1016/j.fertnstert.2008.09.005

30. Dueholm M. Uterine adenomyosis and infertility, review of reproductive outcome after in vitro fertilization and surgery // Acta Obstetricia et Gynecologica Scandinavica. 2017. Vol. 96. P. 715−726. doi: https://doi.org/10.1111/aogs.13158

31. Walsh J. W., Taylor K. J., Rosenfield A. T. Gray scale ultrasonography in the diagnosis of endometriosis and adenomyosis // Am. J. Roentgenol. 1979. Vol. 132. P. 87−90. doi: https://doi.org/10.2214/ajr.132.1.87https://doi.org/10.2214/ajr.132.1.87

32. Ryan K. Cunningham, Mindy M. Horrow, Ryan J. Smith. Adenomyosis: A Sonographic Diagnosis // RadioGraphics. 2018. Vol. 38, № 5. P. 1576−1589. doi: https://doi.org/10.1148/rg.2018180080

33. Demidov V. N., Adamyan L. V., Khachatryan A. K. Ul'trazvukovaya diagnostika endometrioza. II. Vnutrennii endometrioz // Ul'trazvukovaya diagnostika, 1996. № 1. S. 32−42.

34. Koninckx P. R., Martin D. Treatment of deeply infiltrating endometriosis // Treatment. Curr. Opin. Obstet. Gynecol. 1994. Vol. 6. P. 231−241.

Go on Top