Ultrasonographic findings in patients with endometriosis in ovaries and adnexa

image compilation

Abstract

INTRODUCTION: Endometriosis is a condition in which endometrial tissue grows outside the uterine cavity, causing chronic inflammation and disabling pain, depending on its location and severity. Transvaginal ultrasonography is the preferred non-invasive diagnostic method due to its accessibility and low cost, and it is effective in identifying endometrial lesions and signs of pelvic involvement. Ovarian involvement, or endometrioma, is characterized by cystic lesions with dense and uniform content, associated with pelvic pain and infertility, and may also indicate the presence of other endometriotic lesions. OBJECTIVE: To review and describe the ultrasonographic characteristics of endometriosis in the ovaries and adnexa. METHODS: This narrative review focuses on compiling images from articles published in the last five years using the MEDLINE database via PubMed. The Medical Subject Headings (MeSH terms) in English used were “Endometriosis,” “Diagnostic Imaging,” and “Ultrasonography,” in the following search strategy: (Endometriosis) AND (Diagnostic Imaging) OR (Ultrasonography). RESULTS: The typical ultrasonographic finding of endometrioma is presented as a unilocular or multilocular cyst with homogeneous echogenicity and low echogenicity of its contents. However, it may also present anechoic characteristics, mixed echogenicity, or a “ground glass” appearance. Involvement of the adnexa can be evidenced by adhesions or deep infiltrative endometriosis foci on the tubal walls. DISCUSSION AND CONCLUSION: Although there are several classic signs, the importance of a scanning protocol for endometriotic lesions is emphasized. Early detection of lesions is crucial to guide the surgical approach and plan a multidisciplinary strategy, which is essential for more accurate diagnosis and to reduce complication rates. Additional efforts are needed to improve physicians' knowledge of imaging criteria for the early detection of this debilitating disease, as endometriosis has a negative impact on women’s lives in various stages and aspects.