Visualization of sacral nerve roots and sacral plexus on gynecological transvaginal ultrasound: feasibility study

Szabó, Gábor; Madár, I.; Hudelist, G; Arányi, Zsuzsanna; Turtóczki, K; Rigó, János; Ács, Nándor; Lipták, Laura; Fancsovits, Veronika; Bokor, Attila

doi:10.1002/uog.26204

Cited by 6 publications

(1 citation statement)

References 28 publications

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“…With technological advances in the quality of ultrasound resolution, pelvic nerves can be visualized, giving rise to a novel and fascinating field in the implementation of ultrasound imaging, 'pelveoneurosonography' 61 . We have demonstrated herein that increased experience over time leads to increased accuracy of preoperative diagnosis on tracing the origin of a tumor to nerves.…”

Section: Discussionmentioning

confidence: 99%

Imaging in gynecological disease (26): clinical and ultrasound characteristics of benign retroperitoneal pelvic peripheral‐nerve‐sheath tumors

Fischerová

Santos²,

Wong

et al. 2023

Ultrasound in Obstet & Gyne

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ObjectiveTo describe the clinical and sonographic characteristics of benign, retroperitoneal, pelvic peripheral nerve sheath tumors (PNST).MethodsThis was a retrospective, single, gynecologic oncology center study conducted between 1 January 2018 and 31 August 2022. All ultrasound images, clips, and final specimens of benign PNSTs were reviewed by the authors to describe (1) the ultrasound appearance of the tumors using the terminology of the International Ovarian Tumor Analysis (IOTA), Morphological Uterus Sonographic Assessment (MUSA) and Vulvar International Tumor Analysis (VITA) groups on a predefined ultrasound assessment form, (2) the origin of the tumors in relation to nerves and pelvic anatomy, and (3) the correlation between ultrasound features and histotopograms. A review of literature on benign, retroperitoneal, pelvic PNSTs with preoperative ultrasound examination was performed.ResultsFive women (mean age 53 years) with benign, retroperitoneal, pelvic PNSTs were identified: four with schwannomas and one with a neurofibroma, all of which were sporadic and solitary. All patients had good quality ultrasound images and clips and final biopsies of surgically excised tumors, except for one patient managed conservatively with a tru‐cut biopsy. In four of these cases, the findings were incidental. Size range for the five PNSTs was from 31‐50 mm. All five PNSTs were solid, moderately vascular tumors, with non‐uniform echogenicity, well‐circumscribed by hyperechogenic epineurium, and had no acoustic shadowing. Most of the masses were round (n = 4 (80%)), and contained small, irregular, anechoic, cystic spaces (n = 3 (60%)), and hyperechoic areas (n = 4 (80%)). A literature search identified 47 cases of retroperitoneal schwannomas and neurofibromas, the characteristics of which were compared with the cases in our series.ConclusionsOn ultrasound, benign PNSTs were solid, non‐uniform, moderately vascular tumors without acoustic shadowing. Most were round, containing small, irregular, anechoic, cystic spaces, and hyperechoic areas, consistent with degenerative changes on pathology. All tumors were well‐circumscribed by a hyperechogenic rim composed of epineurium. No imaging characteristics reliably differentiated between schwannomas and neurofibromas. In fact, they overlap with the ultrasound appearance of malignant tumors. Hence, ultrasound‐guided biopsy plays a pivotal role in diagnosis, and if confirmed as benign PNSTs, these tumors can undergo ultrasound surveillance.This article is protected by copyright. All rights reserved.

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Section: Discussionmentioning

confidence: 99%

Imaging in gynecological disease (26): clinical and ultrasound characteristics of benign retroperitoneal pelvic peripheral‐nerve‐sheath tumors

Fischerová

Santos²,

Wong

et al. 2023

Ultrasound in Obstet & Gyne

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Are sonographers the future ‘gold standard’ in the diagnosis of endometriosis?

Deslandes,

Panuccio,

Avery

et al. 2024

Sonography

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Diagnosis of endometriosis has traditionally relied on laparoscopic surgery, which was considered the ‘gold standard’ diagnostic tool. This is not ideal as surgery carries risk, is expensive, is difficult to access, and disrupts patients work or education due to the recovery time needed. As such, imaging has been investigated as a potential method for non‐invasive diagnosis, with transvaginal ultrasound showing high diagnostic accuracy for ovarian endometriomas and deep endometriosis. The advances in imaging capability led to recent international guidelines suggesting laparoscopy is no longer the ‘gold‐standard’ for diagnosis and encouraging clinicians to utilise medical imaging as part of their diagnostic work‐up for endometriosis. Imaging is emerging as not only a tool for planning endometriosis surgery but increasingly as the first approach for initial diagnosis. Given that transvaginal ultrasound is the primary imaging modality for assessment of gynaecological conditions, it is inevitable that sonographers will have a significant future role in endometriosis diagnosis. This moves away from endometriosis diagnosis being the exclusive realm of laparoscopic surgeons and increasingly involves medical imaging specialists. This review article will describe the origins of endometriosis ultrasound and the current capabilities of transvaginal ultrasound in this field. The expectations of sonographers in this evolving space will be explored, as well as recent novel research findings to gain insight into what the future of endometriosis diagnosis with ultrasound may look like.

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Entrapped by pain: The diagnosis and management of endometriosis affecting somatic nerves

Thiel,

Kobylianskii,

McGrattan

et al. 2024

Best Practice & Research Clinical Obstetrics & Gynaecol

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Visualization of sacral nerve roots and sacral plexus on gynecological transvaginal ultrasound: feasibility study

Cited by 6 publications

References 28 publications

Imaging in gynecological disease (26): clinical and ultrasound characteristics of benign retroperitoneal pelvic peripheral‐nerve‐sheath tumors

Imaging in gynecological disease (26): clinical and ultrasound characteristics of benign retroperitoneal pelvic peripheral‐nerve‐sheath tumors

Are sonographers the future ‘gold standard’ in the diagnosis of endometriosis?

Entrapped by pain: The diagnosis and management of endometriosis affecting somatic nerves

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