systematic approach to sonographic evaluation of the
TRANSCRIPT
Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurementsA consensus opinion from the International Deep Endometriosis Analysis (IDEA) groupUltrasound Obstet Gynecol 2016;48:318-32.
A. ANTERIOR COMPARTMENT
B. POSTERIOR COMPARTMENT
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August 2018JB55334XX
GE Healthcare
ANTERIOR COMPARTMENT
www.gehealthcare.comJB46414XE 300-17-U003E
POSTERIOR COMPARTMENT
Systematic approach to sonographic evaluation of the pelvis in women with
A consensus opinion from the International Deep Endometriosis Analysis (IDEA) group
Routine evaluation of uterus and adnexa (+ sonographic signs of adenomyosis/presence or absence of endometrioma)FIRST STEP
SECOND STEP
THIRD STEP
FOURTH STEP
Evaluation of transvaginal sonographic “soft markers” (i.e. site-specific tenderness and ovarian mobility
Assessment of status of POD using real-time ultrasound-based “sliding sign”
Assessment for DIE nodules in anterior and posterior compartments
DYN
AMIC
U
LTRA
SON
O-
GRA
PHY
Bowel (rectum & sigmoid)
Vagina
Bladder Peritoneal cavityUterus
Endometriotic nodule Uterosacral ligametsAnal sphincter
Ultrasound Obstet Gynecol 2016;48:318-32
AB
1
2
3
4
5
Bladder base Bladder dome
Spherical lesion
at base
Linear lesion at
base
GE Healthcare
ANTERIOR COMPARTMENT
www.gehealthcare.comJB46414XE 300-17-U003E
POSTERIOR COMPARTMENT
Systematic approach to sonographic evaluation of the pelvis in women with
A consensus opinion from the International Deep Endometriosis Analysis (IDEA) group
Routine evaluation of uterus and adnexa (+ sonographic signs of adenomyosis/presence or absence of endometrioma)FIRST STEP
SECOND STEP
THIRD STEP
FOURTH STEP
Evaluation of transvaginal sonographic “soft markers” (i.e. site-specific tenderness and ovarian mobility
Assessment of status of POD using real-time ultrasound-based “sliding sign”
Assessment for DIE nodules in anterior and posterior compartments
DYN
AMIC
U
LTRA
SON
O-
GRA
PHY
Bowel (rectum & sigmoid)
Vagina
Bladder Peritoneal cavityUterus
Endometriotic nodule Uterosacral ligametsAnal sphincter
Ultrasound Obstet Gynecol 2016;48:318-32
AB
1
2
3
4
5
Rectovaginal septum
Uterosacral ligament
Rectum and rectosigmoid
Torus uterinus
cm 0
Posterior vaginal fornix
“Diablo-like” nodule
Rectal wall
lesion
Forniceal lesion
Forniceal lesion
Forniceal and
recto- sigmoid lesions
Utero- sacral lesion
Intestinal nodule
with progressive narrowing
Intestinal nodule
with regular outline
Utero- sacral lesion
“Mushroom cap” sign
Utero- sacral lesion
Forniceal and
recto- sigmoid lesion
Forniceal lesion
Septum lesion
Septum only
Vaginal wall
Rectal wall
Vaginal and
rectum
11
2
3
4
5
DYNAMIC ULTRASONOGRAPHYFirst step: Routine evaluation of uterus and adnexa (+ sonographic signs of adenomyosis/presence or absence of endometrioma)
Second step: Evaluation of transvaginal sonographic “soft markers” (i.e. site-specific tenderness and ovarian mobility)
Third step: Assessment of status of POD using real-time ultrasound-based “sliding sign”
Fourth step: Assessment for DIE nodules in anterior and posterior compartments
Bowel (rectum and sigmoid)
Vagina
Bladder
Peritoneal cavity
Uterus
Endometriotic nodule
Uterosacral ligaments
Anal sphincter