DIAGNOSTIC ET TRAITEMENT DE LENDOMETRIOSE CHEZ LADOLESCENTE A PROPOS DE 160 CAS

Endometriosis is a chronic gynecological pathology related to the presence of hormonally-dependent endometrial tissue outside the uterus. Its frequency in the adolescent is not negligible with a symptomatology dominated by pelvic pain twisted on the account of dysmenorrhea. Pelvic ultrasound is a basic examination for diagnostic guidance magnetic resonance imaging is more sensitive to visualizing deep endometriosis. Surgical and medical treatments are complementary. The evolution is marked by frequent recurrences in the teenager which can hinder the social life as well as the obstetric prognosis.

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OP20.05: Three-dimensional ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of deep endometriosis

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.13830 ◽

2014 ◽

Vol 44 (S1) ◽

pp. 125-125

Author(s):

S. Guerriero ◽

L. Saba ◽

J. Alcazar ◽

M. Pascual ◽

S. Ajossa ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Three Dimensional ◽

Resonance Imaging ◽

Deep Endometriosis ◽

Magnetic Resonance Imaging Mri

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Early Learning Curve in the Assessment of Deep Pelvic Endometriosis for Ultrasound and Magnetic Resonance Imaging

BioMed Research International ◽

10.1155/2020/8757281 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

T. Indrielle-Kelly ◽

D. Fischerova ◽

P. Hanuš ◽

F. Frühauf ◽

M. Fanta ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Learning Curve ◽

Uterosacral Ligament ◽

Learning Curves ◽

Pelvic Endometriosis ◽

Resonance Imaging ◽

Deep Endometriosis ◽

Kappa Agreement ◽

Radiology Trainee

Purpose. We aimed to compare the learning curves of an ultrasound trainee (obstetrics and gynecology resident) and a radiology trainee when assessing pelvic endometriosis. Methods. Consecutive patients with suspected endometriosis were prospectively enrolled in a tertiary center. They underwent an ultrasound and magnetic resonance imaging preoperatively, which was reported according to the International Deep Endometriosis Analysis (IDEA) group consensus. Trainees reported on deep endometriosis (DE), endometriomas, frozen pelvis, and adenomyosis. Using the Kappa agreement, their findings were compared against laparoscopy/histology and expert findings. The learning curve was considered positive when performance improved over time and indeterminate in all other cases. Results. Reports from thirty-five women were divided chronologically into 3 equal blocks to assess the learning curve. For ultrasound, trainee versus expert showed a positive learning curve in overall pelvic DE assessment. There was an excellent agreement for adenomyosis (Kappa=1.00, p=0.09), frozen pelvis (Kappa=0.90, p=0.01), bowel (Kappa=1.00, p=0.01), and bladder DE assessment (Kappa=1.00, p=0.01). Endometrioma and uterosacral ligament assessment showed an indeterminate curve. For radiology, trainee versus expert showed a positive curve when detecting adenomyosis (Kappa=0.42, p=0.09) and bladder DE (Kappa=1.00, p=0.01). The assessment of endometriomas, frozen pelvis, overall pelvic DE, bowel, and uterosacral ligament DE showed indeterminate curve. Agreement between trainees and laparoscopy/histology showed a positive curve for bladder (both) and frozen pelvis (ultrasound only). Conclusion. A positive learning curve can be seen in some areas of pelvic endometriosis mapping after as little as 35 cases, but a bigger caseload is required to demonstrate the curve in full. The ultrasound trainee had positive learning curves in more anatomical locations (bladder, adenomyosis, overall bowel DE, frozen pelvis) than the radiology trainee (bladder, adenomyosis), which could be down to individual factors, differences in training, or the imaging method itself.

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