systematic approach to sonographic evaluation of the

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