Imaging techniques in endometriosis

Abstract

Endometriosis is a common gynecological condition affecting up to 15% of the general female population. Here, we present a systematic review of imaging techniques of endometriosis. The aim of this review is to determine the most accurate site-specific preoperative diagnostic tools in order to map, locate, evaluate the extension, and stage the disease. There are important reasons to stage endometriosis: to create a common language, to enable specificity of diagnosis, standardize comparisons, and to facilitate research applications. The requirements of an ideal endometriosis classification system are that it be empirically and scientifically based, be of general consensus, have unambiguous definition of terms, be comprehensive in all cases, have a simple translation from anatomic features to verbal description, reflect disease, predict fertility, predict pain relief, be useful to guide treatment, indicate risk of recurrence, identify clinical situations in which it does not apply, be simple to calculate, and be easy to communicate to women. An extensive search of papers regarding imaging techniques in endometriosis was performed in Pubmed from January 1992 to February 2018, including original peer-reviewed papers, reviews, and international guidelines.

Endometriosis and the Urinary Tract: From Diagnosis to Surgical Treatment

“…The two phenotypes of UTE are superficial endometriosis (SE) and deep endometriosis (DE) [ 11 ]. SE can be recognized with a laparoscopy as black, white, or red implants, depending on the degree of fibrosis, scarring, and hemorrhage within the tissue.…”

Examining Diagnostic Options and Classification Systems Available for Endometriosis

“…Among imaging techniques, ultrasound and MRI bear some diagnostic value, though those are not sufficiently specific and sensitive to different types of endometriosis and non-endometriotic lesions. [7][8] According to a Cochrane Database systematic review of imaging modalities for the non-invasive diagnosis of endometriosis, none of the imaging modalities were able to detect overall endometriosis with sufficient accuracy. 9 Despite the fact that imaging may give useful indications, visual inspection of pelvic and extrapelvic lesions at laparoscopy with histological confirmation remains the most reliable procedure towards the detection of endometriosis and its classification.…”

“…10,11 Nevertheless, laparoscopy is considered to be the standard modality for the diagnosis of endometriosis. 7 Furthermore, laparoscopy can be applied for the treatments in which endometriomas may be cauterised or removed and adhesions can be lysed. 7 Laparoscopic surgery is, however, associated with an increased risk of intraoperative injury to bowel, bladder, ureter, and blood vessels.…”

Endometriosis and the Urinary Tract: from Diagnosis to Surgical Treatment

“…The two phenotypes of UTE are superficial endometriosis (SE) and deep endometriosis (DE). 9 SE can be recognized at laparoscopy as black, white, or red implants depending on the degree of fibrosis, scarring, and hemorrhage within the tissue. DE is defined by the invasion of endometriallike glands and stroma at least 5 mm beneath the peritoneal surface.…”