Anatomical Distribution of Deep Endometriosis on Transvaginal Ultrasound and Clinical Features: Implications on Non-Invasive Diagnosis

2021 ◽  
Vol 28 (11) ◽  
pp. S87-S88
Author(s):  
R.M. Rocha ◽  
J.V.C. Zanardi ◽  
C. Uzuner ◽  
J. Mak ◽  
G. Condous
Keyword(s):  
Clinical Features ◽  
Transvaginal Ultrasound ◽  
Deep Endometriosis ◽  
Anatomical Distribution ◽  
Non Invasive

P–331 The #Enzian classification: A comprehensive non-invasive and surgical description system for endometriosis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J Keckstein ◽  
H Gernot
Keyword(s):  
Classification System ◽  
Working Group ◽  
Complex Disease ◽  
Diagnostic Methods ◽  
Anatomical Location ◽  
Ovarian Endometriosis ◽  
Deep Endometriosis ◽  
Non Invasive ◽  
Complete Mapping

Abstract Study question Is there a classification for a complete mapping of endometriosis, including anatomical location, size of the lesions, and degree of involvement that can be used with both, diagnostics and surgery? Summary answer #Enzian classification improves in both, non-invasive diagnostic methods and surgical therapy for endometriosis as a universally usable classification system for all aspects of the disease. What is known already The most commonly used r-ASRM classification has certain limitations due to its incomplete description of DE, the complexity of the classification, and lack of reproducibility. In contrast, the Enzian classification, which has been implemented in the last decade, has proved to be the most suitable for the description of DE. However, since it does not include peritoneal and ovarian lesions and lacks a description of tubo-ovarian adhesions, it has not gained full acceptance. A combination of classification with different systems such as r-ASRM, EFI score and Enzian, may complicate classification of the disease due to overlaps and time-consuming documentation. Study design, size, duration The result is a consensus of a panel of renowned clinicians (working group), gynaecological surgeons and sonographers with extensive expertise in diagnosis and therapy of endometriosis. A first draft was written in 2019 by a joint effort of the first and last author and sent to all working group members. Taking all comments into account, a revised draft was then sent to all coauthors and repeated until a consensus was reached (9 revisions). Participants/materials, setting, methods Criteria used to invite the experts to participate in this consensus process included their having significant peer-reviewed publications in the field of diagnosis and management of endometriosis. Main results and the role of chance Our current proposal is the first of its kind to universally describe superficial and deep endometriosis, ovarian endometriosis, adenomyosis and adhesions by using a classification system that can be applied by gynaecologists, surgeons, sonographers and radiologists following the same principles. The correlation between preoperative and surgical staging, on the basis of the Enzian scheme, allows for consistent and clear classification of endometriosis, especially DE. Endometriosis can be mapped completely with one single classification system enabling the use of one common language. Limitations, reasons for caution This classification system is anatomically logical and should be easy to use. Further studies are ongoing and are needed to provide proof for the applicability, reproducibility and accuracy of the #Enzian classification for the description of endometriosis. Wider implications of the findings: #Enzian classification now enabled better coverage of various endometriosis localizations. The possibility of using this system preoperatively as well as postoperatively within the framework of diagnostics offers clinicians a significant improvement in the care of patients with such a complex disease. Trial registration number Not applicable

scholarly journals Noninvasive prenatal testing for chromosome aneuploidies and subchromosomal microdeletions/microduplications in a cohort of 42,910 single pregnancies with different clinical features

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Yibo Chen ◽  
Qi Yu ◽  
Xiongying Mao ◽  
Wei Lei ◽  
Miaonan He ◽  
...  
Keyword(s):  
Clinical Features ◽  
Sex Chromosome ◽  
Prenatal Testing ◽  
Maternal Plasma ◽  
Trisomy 13 ◽  
Noninvasive Prenatal Testing ◽  
Detection Rates ◽  
Non Invasive ◽  
Cell Free Fetal Dna ◽  
Sex Chromosome Aneuploidies

Abstract Background Since the discovery of cell-free DNA (cfDNA) in maternal plasma, it has opened up new approaches for non-invasive prenatal testing. With the development of whole-genome sequencing, small subchromosomal deletions and duplications could be found by NIPT. This study is to review the efficacy of NIPT as a screening test for aneuploidies and CNVs in 42,910 single pregnancies. Methods A total of 42,910 single pregnancies with different clinical features were recruited. The cell-free fetal DNA was directly sequenced. Each of the chromosome aneuploidies and the subchromosomal microdeletions/microduplications of PPV were analyzed. Results A total of 534 pregnancies (1.24%) were abnormal results detected by NIPT, and 403 pregnancies had underwent prenatal diagnosis. The positive predictive value (PPV) for trisomy 21(T21), trisomy 18 (T18), trisomy 13 (T13), sex chromosome aneuploidies (SCAs), and other chromosome aneuploidy was 79.23%, 54.84%, 13.79%, 33.04%, and 9.38% respectively. The PPV for CNVs was 28.99%. The PPV for CNVs ≤ 5 Mb is 20.83%, for within 5–10 Mb 50.00%, for > 10 Mb 27.27% respectively. PPVs of NIPT according to pregnancies characteristics are also different. Conclusion Our data have potential significance in demonstrating the usefulness of NIPT profiling not only for common whole chromosome aneuploidies but also for CNVs. However, this newest method is still in its infancy for CNVs. There is still a need for clinical validation studies with accurate detection rates and false positive rates in clinical practice.

scholarly journals OP16.03: Extended transvaginal ultrasound in deep endometriosis: use of bowel preparation and acoustic window with intravaginal gel

2013 ◽  
Vol 42 (s1) ◽  
pp. 92-93
Author(s):  
M. León ◽  
J. Alcazar ◽  
H. Vaccaro ◽  
J. Martinez ◽  
J. Gutierrez ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Transvaginal Ultrasound ◽  
Deep Endometriosis ◽  
Acoustic Window

Initial Accuracy of and Learning Curve for Transvaginal Ultrasound with Bowel Preparation for Deep Endometriosis in a US Tertiary Care Center

2017 ◽  
Vol 24 (7) ◽  
pp. 1170-1176 ◽  
Author(s):  
Scott W. Young ◽  
Nirvikar Dahiya ◽  
Maitray D. Patel ◽  
Mauricio S. Abrao ◽  
Javier F. Magrina ◽  
...  
Keyword(s):  
Learning Curve ◽  
Bowel Preparation ◽  
Transvaginal Ultrasound ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Deep Endometriosis

scholarly journals Adenomyosis in Infertile Women : A Review

2016 ◽  
Vol 30 (2) ◽  
pp. 105-108
Author(s):  
Shakeela Ishrat ◽  
Parveen Fatima
Keyword(s):  
Magnetic Resonance Imaging ◽  
Transvaginal Ultrasound ◽  
Endometrial Receptivity ◽  
Early Age ◽  
Resonance Imaging ◽  
Infertile Women ◽  
Non Invasive ◽  
Future Pregnancy ◽  
And Function ◽  
Work Up

Adenomyosis is found during infertility work up in many women who delay pregnancy till their late thirties and in some women in their early age. Dysregulation of myometrial architecture and function and altered endometrial receptivity are among the possible mechanisms by which adenomyosis causes infertility. Adenomyosis and endometriosis may have similar pathogenesis as they have frequent association in women. Adenomyosis can be reliably diagnosed in symptomatic infertile women by non invasive means such as transvaginal ultrasound and magnetic resonance imaging as well as hysterosalpingography, hysteroscopy and laparoscopy. Early diagnosis by non-invasive means followed by surgical (adenomyomectomy) or non-surgical (MRgFUS) treatment of focal adenomyosis have promising effect on future pregnancy whereas diffuse severe adenomyosis have poor prognosis.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 105-108

scholarly journals ACCURACY OF TRANSVAGINAL ULTRASONOGRAPHY COMPARED TO ENDOMETRIAL BIOPSY FOR THE ETIOLOGICAL DIAGNOSIS OF ABNORMAL PERIMENOPAUSAL BLEEDING

2017 ◽  
Vol 90 (1) ◽  
pp. 33-39
Author(s):  
Renata Nicula ◽  
Doru Diculescu ◽  
Codruţa Claudia Lencu ◽  
Răzvan Ciortea ◽  
Carmen Elena Bucuri ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
Endometrial Adenocarcinoma ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Accurate Identification ◽  
Non Invasive ◽  
Number Of Patients ◽  
Invasive Method

Background and aims. Perimenopause is marked by clinical manifestations which disturb everyday life and which may also hide a pathomorphological, more precisely endometrial, substrate. An accurate early diagnosis established by accessible, non-invasive methods is very important for the therapeutic management.Method. The study included 103 patients aged between 41.5–55.11 years, divided into 3 age groups: 40-44 years (n=10), 45-49 years (n=54) and ≥50 years (n=39).Results. Certain risk factors of endometrial neoplasm or premalignant conditions were evidenced, their accurate identification being useful in limiting the number of patients with abnormal uterine bleeding (AUB) submitted to diagnostic screening. The most common cause of AUB in our study was fibroma, followed by functional causes.Conclusions. Transvaginal ultrasound (TVUS) represents a minimally invasive method for the screening of perimenopausal patients with AUB, especially to rule out endometrial adenocarcinoma (EAC). TVUS sensitivity was higher than clinical diagnosis in case of leiomioma, polypi and EAC. TVUS was more accurate in the diagnosis of EAC, polypi and leiomioma.

scholarly journals Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery

2021 ◽  
Author(s):  
Meritxell Gracia ◽  
Cristian de Guirior ◽  
Marta Valdés-Bango ◽  
Mariona Rius ◽  
Cristina Ros ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Laparoscopic Surgery ◽  
Surgical Complications ◽  
Transvaginal Ultrasound ◽  
Surgical Time ◽  
Deep Endometriosis ◽  
Analysis Group ◽  
Increased Risk ◽  
The Impact

Abstract Background Deep endometriosis (DE) occurs in 15–30% of patients with endometriosis and is associated with concomitant adenomyosis in around 49% of cases. There are no data about the effect of the presence of adenomyosis in terms of surgical outcomes and complications. Thus, the aim of the present study was to evaluate the impact of adenomyosis on surgical complications in women with deep endometriosis undergoing laparoscopic surgery. Methods A retrospective cohort study including women referred to the endometriosis unit of a referral teaching hospital. Two expert sonographers preoperatively diagnosed DE and adenomyosis. DE was defined according to the criteria of the International Deep Endometriosis Analysis group. Adenomyosis was considered when 3 or more ultrasound criteria of the Morphological Uterus Sonographic Assessment group were present. Demographical variables, current medical treatment, symptoms, DE location, surgical time, hospital stay and difference in pre and post hemoglobin levels were collected. The Clavien-Dindo classification was used to assess surgical complications, and multivariate analysis was performed to compare patients with and without adenomyosis. Results 157 DE patients were included into the study; 77 (49.05%) had adenomyosis according to transvaginal ultrasound (TVS) and were classified in the A group, and 80 (50.95%) had no adenomyosis and were classified in the noA group. Adenomyosis was associated with a higher rate of surgical complications: 33.76% (A group) vs. 12.5% (noA group) (p < 0.001). Multivariate analysis showed a 4.56-fold increased risk of presenting complications in women with adenomyosis (CI: 1.9–11.3; p = 0.001) independently of undergoing hysterectomy. There was a statistically significant association between the number of criteria of adenomyosis present in each patient and the proportion of patients presenting surgical complications (p < 0.001). Conclusions Adenomyosis increases the risk of presenting complications in DE surgery after controlling for demographic, clinical and surgical factors and should be considered an independent preoperative risk factor of surgical complications.

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