Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group

Abstract

The IDEA (International Deep Endometriosis Analysis group) statement is a consensus opinion on terms, definitions and measurements that may be used to describe the sonographic features of the different phenotypes of endometriosis. Currently, it is difficult to compare results between published studies because authors use different terms when describing the same structures and anatomical locations. We hope that the terms and definitions suggested herein will be adopted in centers around the world. This would result in consistent use of nomenclature when describing the ultrasound location and extent of endometriosis. We believe that the standardization of terminology will allow meaningful comparisons between future studies in women with an ultrasound diagnosis of endometriosis and should facilitate multicenter research. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Transvaginal sonography with vs without bowel preparation in diagnosis of rectosigmoid endometriosis: prospective study

“…In the current study, TVS was used to estimate the distance between the lower margin of the more caudal nodule and the anal verge. The consensus of the IDEA group, reviews by experts and clinical studies support the use of TVS in measuring this distance. However, while this measurement can easily be performed in the case of rectal nodules, it may be less precise when the endometriotic nodules are located on the rectosigmoid junction or on the sigmoid.…”

“…Since TVS allows visualization of the normal rectal wall layers, infiltration of the intestinal submucosa was estimated (Figure ). The location of the intestinal nodules was classified according to the definition of the International Deep Endometriosis Analysis (IDEA) group into: lower anterior rectal nodules (located below the level of the insertion of the uterosacral ligaments on the cervix and thus retroperitoneal), upper anterior rectal nodules (located above the insertion of the uterosacral ligaments on the cervix and thus visible at laparoscopy), nodules of the rectosigmoid junction (located at the level of the uterine fundus) and anterior sigmoid nodules (located above the level of the uterine fundus). The distance between the lower margin of the more caudal nodule and the anal verge was estimated.…”

Sonographic classification and reporting system for diagnosing adenomyosis

“…To help identify serosal involvement of adenomyosis, the presence of sliding of or fixed viscera (bowels) against the uterus should always be recorded. Discussion of ultrasound examination with regard to concomitant superficial or deep endometriosis is beyond the scope of this Opinion.…”

How to perform a gynaecological ultrasound in the paediatric or adolescent patient

“…The usefulness of ultrasound for detecting ovarian endometriomas is well established. In recent years, the popularity of ultrasound for deep infiltrating endometriosis (DIE) has expanded rapidly and its usefulness well reported . Both endometriomas and DIE are rare within the adolescent population.…”

“…In recent years, the popularity of ultrasound for deep infiltrating endometriosis (DIE) has expanded rapidly and its usefulness well reported. 20 Both endometriomas and DIE are rare within the adolescent population. Most adolescents with endometriosis will have stage I or stage II disease which is superficial and not appreciated on ultrasound (even TVS).…”