Superficial Endometriosis at Ultrasound Examination—A Diagnostic Criteria Proposal
Marcelo Pedrassani,
Stefano Guerriero,
María Ángela Pascual,
Silvia Ajossa,
Betlem Graupera,
Mariachiara Pagliuca,
Sérgio Podgaec,
Esdras Camargos,
Ygor Vieira de Oliveira,
Juan Luis Alcázar
Affiliations
Marcelo Pedrassani
CLINUS Ultrasound Clinic, Florianópolis 88015-200, Brazil
Stefano Guerriero
Centro Integrato di Procreazione Medicalmente Assistita e Diagnostica Ostetrico-Ginecologica, Azienda Ospedaliero Universitaria—Policlinico Duilio Casula, Monserrato, University of Cagliari, 09042 Cagliari, Italy
María Ángela Pascual
Department of Obstetrics, Gynecology, and Reproduction, Hospital Universitari Dexeus, 08028 Barcelona, Spain
Silvia Ajossa
Centro Integrato di Procreazione Medicalmente Assistita e Diagnostica Ostetrico-Ginecologica, Azienda Ospedaliero Universitaria—Policlinico Duilio Casula, Monserrato, University of Cagliari, 09042 Cagliari, Italy
Betlem Graupera
Department of Obstetrics, Gynecology, and Reproduction, Hospital Universitari Dexeus, 08028 Barcelona, Spain
Mariachiara Pagliuca
Centro Integrato di Procreazione Medicalmente Assistita e Diagnostica Ostetrico-Ginecologica, Azienda Ospedaliero Universitaria—Policlinico Duilio Casula, Monserrato, University of Cagliari, 09042 Cagliari, Italy
Sérgio Podgaec
Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-010, Brazil
Esdras Camargos
Clinic of Gynecological Surgery and Endometriosis at Hospital Maternidade Carmela Dutra and Hospital Baia Sul, Florianópolis 88015-270, Brazil
Ygor Vieira de Oliveira
Hospital Maternidade Carmela Dutra, Florianópolis 88015-270, Brazil
Juan Luis Alcázar
Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, 31008 Pamplona, Spain
The actual prevalence of superficial endometriosis is not known. However, it is considered the most common subtype of endometriosis. The diagnosis of superficial endometriosis remains difficult. In fact, little is known about the ultrasound features of superficial endometriotic lesions. In this study, we aimed to describe the appearance of superficial endometriosis lesions at ultrasound examination, with laparoscopic and/or histologic correlation. This is a prospective study on a series of 52 women with clinical suspicion of pelvic endometriosis who underwent preoperative transvaginal ultrasound and received a confirmed diagnosis of superficial endometriosis via laparoscopy. Women with ultrasound or laparoscopic findings of deep endometriosis were not included. We observed that superficial endometriotic lesions may appear as a solitary lesions, multiple separate lesions, and cluster lesions. The lesions may exhibit the presence of hypoechogenic associated tissue, hyperechoic foci, and/or velamentous (filmy) adhesions. The lesion may be convex, protruding from the peritoneal surface, or it may appear as a concave defect in the peritoneum. Most lesions exhibited several features. We conclude that transvaginal ultrasound may be useful for diagnosing superficial endometriosis, as these lesions may exhibit different ultrasound features.
