Ultrasonographic soft markers for detection of rectosigmoid deep endometriosis

Guerriero, S.; Ajossa, Silvia; Pascual, M.; Rodríguez, I.; Piras, A.; Perniciano, M.; Saba, Luca; Paoletti, Anna Maria; Mais, Valerio; Alcázar, Juan Luis

doi:10.1002/uog.20289

Cited by 22 publications

(13 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…United States radiology practices have been slow to adopt this technique because it is not a traditional part of the pelvic anatomy which has been routinely assessed by sonography. The sliding sign has been shown to have high specificity for the detection of posterior compartment adhesions but also has been shown to increase the detection of rectal DIE 7,16 . Our study showed that implementation of the sliding sign during routine protocol imaging for patients with appropriate clinical indications leads to an increase in the detection of posterior compartment DIE.…”

Section: Discussionmentioning

confidence: 57%

Impact of Uterine Sliding Sign in Routine United States Ultrasound Practice

Young

Wasson

et al. 2020

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objectives The study aim was to evaluate the diagnostic performance of the uterine sliding sign in predicting deeply infiltrating endometriosis in the setting of non‐physician sonographers performing but not interpreting the maneuver. The impact of uterine sliding sign has not been previously demonstrated in this practice setting. Methods Physicians' remote interpretations of transvaginal ultrasound examinations in 2016, before uterine sliding sign, were compared to examinations in 2019 after addition of uterine sliding sign to determine the diagnostic rates. Surgical and histopathological results were reviewed to determine sensitivity and specificity of the respective exam techniques. Results Two hundred eighty‐five transvaginal ultrasounds were performed in 2016 and 390 sliding sign ultrasounds in 2019. The number of deeply infiltrating endometriosis cases identified increased significantly from 2% to 6% during the study period (chi‐square, Fisher's exact test p = .012). The sensitivity and specificity of routine pelvic sonography for detecting deeply infiltrating endometriosis improved from 36%/94% to 68%/98%. Conclusions Uterine sliding sign videos should be included in the standard sonographic protocol for patients presenting with chronic pelvic pain, endometriosis history, or sonographic evidence of endometriosis in the setting of physicians interpreting sonographic images obtained by non‐physicians.

show abstract

Section: Discussionmentioning

confidence: 57%

Impact of Uterine Sliding Sign in Routine United States Ultrasound Practice

Young

Wasson

et al. 2020

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

“…Interpretation of this sign involves a steep learning curve and requires a minimum degree of training 82 , although the number of practice scans required to be considered competent may vary by trainee 83 . Ovarian immobility at the time of TVS is another important soft marker that has been associated with OE 84,85 , posterior-compartment DE 86 and ipsilateral SE [87][88][89] , as ipsilateral pelvic sidewall SE is less likely to be present in people with a mobile ovary (in the absence of DE or OE) 89 . Ovarian immobility to the pelvic sidewall is important to identify, using preoperative TVS, for patient counseling and surgical planning, as these women are at increased risk of requiring pelvic sidewall adhesiolysis and ureterolysis 90 .…”

Section: Ultrasoundmentioning

confidence: 99%

Strengths and limitations of diagnostic tools for endometriosis and relevance in diagnostic test accuracy research

Pascoal

Wessels

Aas-Eng

et al. 2022

Ultrasound in Obstet & Gyne

Self Cite

View full text Add to dashboard Cite

Endometriosis is a chronic systemic disease that can cause pain, infertility and reduced quality of life. Diagnosing endometriosis remains challenging, which yields diagnostic delays for patients. Research on diagnostic test accuracy in endometriosis can be difficult due to verification bias, as not all patients with endometriosis undergo definitive diagnostic testing. The purpose of this State-of-the-Art Review is to provide a comprehensive update on the strengths and limitations of the diagnostic modalities used in endometriosis and discuss the relevance of diagnostic test accuracy research pertaining to each. We performed a comprehensive literature review of the following methods: clinical assessment including history and physical examination, biomarkers, diagnostic imaging, surgical diagnosis and histopathology. Our review suggests that, although non-invasive diagnostic methods, such as clinical assessment, ultrasound and magnetic resonance imaging, do not yet qualify formally as replacement tests for surgery in diagnosing all subtypes of endometriosis, they are likely to be appropriate for advanced stages of endometriosis. We also demonstrate in our review that all methods have strengths and limitations, leading to our conclusion that there should not be a single gold-standard diagnostic method for endometriosis, but rather, multiple accepted diagnostic methods appropriate for different circumstances.

show abstract

“…However, especially in patients with vaginal lesions, the combination of imaging techniques and clinical examination, including speculum examination and bimanual palpation, leads to a clearer view of the structures involved [21][22][23]. In addition, the dynamic examination includes not only imaging of endometriosis but also assessment of motility of the pelvic organs (sliding signs), tissue elasticity, and tenderness of affected organs (compartments) [6,24].…”

Section: Ultrasonography Does Not Allow the Definite Exclusion Of End...mentioning

confidence: 99%

“…Author contributions All the authors contributed to the study conception and design. The first draft of the manuscript was written by JK, , T [6,19], A [5,19,36], B [5,19,36], C [19,24,35,55], FA [39], and FU [19]. B Visualization of the other F compartments (except FA, FB, and FU) according to the #Enzian classification.…”

Section: Conclusion and Perspectivementioning

confidence: 99%

See 1 more Smart Citation

Expert opinion on the use of transvaginal sonography for presurgical staging and classification of endometriosis

Keckstein

Hoopmann

Merz³

et al. 2022

Arch Gynecol Obstet

View full text Add to dashboard Cite

Gynecological ultrasonography plays a central role in the management of endometriosis. The rapid technical development as well as the currently increasing evidence for non-invasive diagnostic methods require an updated compilation of recommendations for the use of ultrasound in the management of endometriosis. The present work aims to highlight the accuracy of sonography for diagnosing and classifying endometriosis and will formulate the present list of key messages and recommendations. This paper aims to demonstrate the accuracy of TVS in the diagnosis and classification of endometriosis and to discuss the clinical applications and consequences of TVS findings for indication, surgical planning and assessment of associated risk factors. (1) Sophisticated ultrasound is the primary imaging modality recommended for suspected endometriosis. The examination procedure should be performed according to the IDEA Consensus. (2) Surgical intervention to confirm the diagnosis alone is not recommended. A preoperative imaging procedure with TVS and/or MRI is strongly recommended. (3) Ultrasound examination does not allow the definitive exclusion of endometriosis. (4) The examination is primarily transvaginal and should always be combined with a speculum and a bimanual examination. (5) Additional transabdominal ultrasonography may enhance the accuracy of the examination in case of extra pelvic disease, extensive findings or limited transvaginal access. (6) Sonographic assessment of both kidneys is mandatory when deep endometriosis (DE) and endometrioma are suspected. (7) Endometriomas are well defined by sonographic criteria. When evaluating the ovaries, the use of IOTA criteria is recommended. (8) The description of sonographic findings of deep endometriosis should be systematically recorded and performed using IDEA terminology. (9) Adenomyosis uteri has sonographically well-defined criteria (MUSA) that allow for detection with high sensitivity and specificity. MRI is not superior to differentiated skilled ultrasonography. (10) Classification of the extent of findings should be done according to the #Enzian classification. The current data situation proves the best possible prediction of the intraoperative situs of endometriosis (exclusive peritoneum) for the non-invasive application of the #Enzian classification. (11) Transvaginal sonographic examination by an experienced examiner is not inferior to MRI diagnostics regarding sensitivity and specificity in the prediction of the extent of deep endometriosis. (12) The major advantage of non-invasive imaging and classification of endometriosis is the differentiated planning or possible avoidance of surgical interventions. The recommendations represent the opinion of experts in the field of non-invasive and invasive diagnostics as well as therapy of endometriosis. They were developed with the participation of the following national and international societies: DEGUM, ÖGUM, SGUM, SEF, AGEM/DGGG, and EEL.

show abstract

Ultrasonographic soft markers for detection of rectosigmoid deep endometriosis

Cited by 22 publications

References 30 publications

Impact of Uterine Sliding Sign in Routine United States Ultrasound Practice

Impact of Uterine Sliding Sign in Routine United States Ultrasound Practice

Strengths and limitations of diagnostic tools for endometriosis and relevance in diagnostic test accuracy research

Expert opinion on the use of transvaginal sonography for presurgical staging and classification of endometriosis

Contact Info

Product

Resources

About