Sonographic features of endometriosis infiltrating the lateral parametrium.
J Gynecol Obstet Hum Reprod
; 50(7): 102116, 2021 Sep.
Article
em En
| MEDLINE
| ID: mdl-33737251
ABSTRACT
OBJECTIVE:
Lateral parametrium endometriosis (LPE) can be associated with infiltration of ureters and hypogastric plexus, causing severe painful symptoms and functional impairment, and requiring complex and extensive surgery. The aim of this study was to evaluate the presentation of LPE lesions at transvaginal ultrasound, identifying sonographic features for disease recognition and mapping.METHODS:
This was a retrospective case-series of women with sonographic suspect of LPE confirmed at surgical exploration. We carried out a descriptive analysis of the ultrasound patterns of presentation and compared the features of the lesions according to their location cranially or caudally to the uterine artery.RESULTS:
Our population included 23 women, with a total of 26 parametrial lesions all of them were hypoechoic, with absence of vascularization. Lesions lying above the uterine artery presented more frequently as ill-defined nodules (78.6 %, p < 0.01) and were associated with ipsilateral reduced or absent ovarian mobility (92.9 %, p < 0.01); the ones located below the uterine artery appeared more frequently as fan-shaped lesions with retraction of the surrounding tissues (83.3 %). Ureteral involvement was observed at surgery in 43.5 % of cases. In all patients, deep infiltrating endometriosis of the posterior compartment was observed the utero-sacral ligaments were the most common location affected concurrently.CONCLUSIONS:
LPE may present at transvaginal sonography as hypoechoic, not vascularized lesions, most frequently with a nodular or with a fan-shaped appearance, respectively cranially or caudally to the uterine artery. Reduced ovarian sliding and ureteral involvement are commonly associated.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Peritônio
/
Endometriose
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Gynecol Obstet Hum Reprod
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Itália