Noninvasive ultrasound diagnosis of endometriosis
March 16, 2020
Can technology help provide answers to a complex condition? This guide demonstrates how to use ultrasound as a first-line diagnostic tool.
George Condous, MBBS
Superficial endometriosis
March 1, 2020
In this clip, fluid within the rectouterine pouch introduced following saline-infusion sonoPODography allows for appreciation of adhesions and a peritoneal pocket (enclosed fluid due to a defect in the peritoneum). These are two classic features of superficial endometriosis.
Retroverted uterus, negative sliding sign
March 1, 2020
Although not clearly depicted in this clip, deep endometriosis likely is present posterior to the uterus at the level of the internal cervical os, as demonstrated by the irregular, hypoechoic area.
Retroverted uterus, positive sliding sign
March 1, 2020
The uterine fundus is being pushed cephalad by the transvaginal ultrasound probe, eliciting smooth sliding of the uterine fundus over the bowel. Some fluid is noted within the rectouterine pouch, which often suggests a non-obliterated pouch.
Anteverted uterus, negative sliding sign
March 1, 2020
In this case, there is a fixed ovary posteriorly and subtle hypoechoic nodule posterior to the uterus at the level of the internal cervical os, suggesting of deep endometriosis of the torus uterinus.
Anteverted uterus, positive sliding sign
March 1, 2020
Pressure is being applied to the uterus by the ultrasound operator’s non-scanning hand, eliciting smooth sliding of the posterior uterine serosa over the bowel. Some fluid is noted within the rectouterine pouch, which often suggests a non-obliterated pouch
Uterosacral ligament deep endometriosis nodule causing hydroureter
March 1, 2020
A hypoechoic deep endometriosis nodule is noted within the hyperechoic uterosacral ligament, infiltrating the parametrium
Uterosacral ligament deep endometriosis nodule
March 1, 2020
A hypoechoic deep endometriosis nodule is noted within the hyperechoic uterosacral ligament.
Uterosacral ligament deep endometriosis nodule
March 1, 2020
A hypoechoic deep endometriosis nodule is noted within the hyperechoic uterosacral ligament. In this case, there is an ovary containing an endometrioma fixed to the uterosacral ligament nodule.
Normal uterosacral ligament and rectouterine pouch peritoneum
March 1, 2020
The beginning of the clip depicts a thin hyperechoic layer just deep to the vagina, which represents the rectouterine pouch peritoneum.
