Opportunities and clinical significance of preoperative diagnosis of infiltrative endometriosis
- Authors: Podzolkova N.M.1,2, Kuznetsov R.E.1,2, Glazkova O.L.1,2, Gorozhanina A.A.1,2, Churayants V.V.2, Romanovskaya O.A.2, Sozaeva L.G.1, Cheporev L.A.2
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Affiliations:
- Russian Medical Academy of Continuous Professional Education
- Botkin City Clinical Hospital
- Issue: Vol 24, No 5 (2022)
- Pages: 342-347
- Section: ORIGINAL ARTICLE
- URL: https://journals.rcsi.science/2079-5831/article/view/106088
- DOI: https://doi.org/10.26442/20795696.2022.5.201820
- ID: 106088
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Abstract
Aim. To optimize preoperative diagnosis of infiltrative forms of genital endometriosis.
Materials and methods. We analyzed the results of the preoperative examination and surgical treatment of 667 patients from 22 to 49 years old (31.4 [27.3; 34.2]) with external endometriosis presented with pelvic pain, dysmenorrhea, dyspareunia (n=580), and primary or secondary infertility (n=215). The duration of the disease ranged from 1 to 16 years. Seventy-eight (11.69%) patients had a history of surgery for external endometriosis. The serum concentration of the CA-125 tumor marker was measured by immunochemiluminescence assay. Colonoscopy was performed in 655 cases, and cystoscopy in 66 cases. In addition, pelvic ultrasound was performed for all patients. Pelvic magnetic resonance imaging (MRI) was performed with an intravenous bolus injection of a contrast agent.
Results. Patients with endometrioid ovarian cysts (n=564) and "minor" forms of endometriosis (n=44) predominated. Endometrioid infiltrates occurred in 59 (8.84%) patients. In the group of patients with infiltrates, 18.64% had a history of surgery for endometriosis; 5.7% had a recurrence. Patients with retrocervical endometriosis and endometriosis of uterosacral ligaments predominated among females with infiltrative forms. No statistically significant differences in CA-125 concentration between patients with and without infiltrates were observed. The infiltrate was revealed, and its topography was described in 49 (83.05%) patients using ultrasound and 56 (94.81%) patients using MRI. All patients with dysuria had ultrasound, MRI, colonoscopy and cystoscopy.
Conclusion. The combined use of pelvic ultrasound and MRI provides high accuracy in diagnosing infiltrative endometriosis.
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##article.viewOnOriginalSite##About the authors
Natalia M. Podzolkova
Russian Medical Academy of Continuous Professional Education; Botkin City Clinical Hospital
Author for correspondence.
Email: podzolkova@gmail.com
ORCID iD: 0000-0001-8991-1369
D. Sci. (Med.), Prof.
Russian Federation, Moscow; MoscowRoman E. Kuznetsov
Russian Medical Academy of Continuous Professional Education; Botkin City Clinical Hospital
Email: r.e.kuznetsov@yandex.ru
ORCID iD: 0000-0002-1061-4271
D. Sci. (Med.)
Russian Federation, Moscow; MoscowOlga L. Glazkova
Russian Medical Academy of Continuous Professional Education; Botkin City Clinical Hospital
Email: glazkova-ol-le@yandex.ru
ORCID iD: 0000-0001-9324-2866
Cand. Sci. (Med.)
Russian Federation, Moscow; MoscowAnastasiya A. Gorozhanina
Russian Medical Academy of Continuous Professional Education; Botkin City Clinical Hospital
Email: agorozhanina@list.ru
ORCID iD: 0000-0003-4543-2088
Graduate Student
Russian Federation, Moscow; MoscowVladimir V. Churayants
Botkin City Clinical Hospital
Email: churaiants@mail.ru
ORCID iD: 0000-0001-5291-8559
Cand. Sci. (Med.)
Russian Federation, MoscowOlga A. Romanovskaya
Botkin City Clinical Hospital
Email: olromanovs@rambler.ru
ORCID iD: 0000-0001-9429-6102
Ultrasound Doctor
Russian Federation, MoscowLarisa G. Sozaeva
Russian Medical Academy of Continuous Professional Education
Email: sozaewa@mail.ru
ORCID iD: 0000-0002-1793-5684
Cand. Sci. (Med.)
Russian Federation, MoscowLeonid A. Cheporev
Botkin City Clinical Hospital
Email: cheporev@mail.ru
ORCID iD: 0000-0001-9150-0200
Obstetrician-Gynecologist
Russian Federation, MoscowReferences
- Эндометриоз. Клинические рекомендации Министерства здравоохранения Российской Федерации, 2016 [Endometrioz. Klinicheskie rekomendatsii ministerstva zdravookhraneniia Rossiiskoi Federatsii, 2016 (in Russian)].
- Koninckx PR, Ussia A, Adamyan L, et al. Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril. 2012;98(3):564-71. doi: 10.1016/j.fertnstert.2012.07.1061
- Nisenblat V, Bossuyt PMM, Farquhar C, et al. Imaging modalities for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016;2(2):CD009591. doi: 10.1002/14651858.CD009591.pub2
- Ruffo G, Scopelliti F, Manzoni A, et al. Long-term outcome after laparoscopic bowel resections for deep infiltrating endometriosis: a single-center experience after 900 cases. Biomed Res Int. 2014;2014:463058. doi: 10.1155/2014/463058
- Dunselman GAJ, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29(3):400-12. doi: 10.1093/humrep/det457
- Van den Bosch T, Van Schoubroeck D. Ultrasound diagnosis of endometriosis and adenomyosis: State of the art. Best Pract Res Clin Obstet Gynaecol. 2018;51:16-24. doi: 10.1016/j.bpobgyn.2018.01.013
- Ballard K, Lane H, Hudelist G, et al. Can specific pain symptoms help in the diagnosis of endometriosis? A cohort study of women with chronic pelvic pain. Fertil Steril. 2010;94(1):20-7. doi: 10.1016/j.fertnstert.2009.01.164
- Guerriero S, Condous G, van den Bosch T, et al. 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. Ultrasound Obstet Gynecol. 2016;48(3):318-32. doi: 10.1002/uog.15955
- Guerriero S, Saba L, Pascual MA, et al. Transvaginal ultrasound vs magnetic resonance imaging for diagnosing deep infiltrating endometriosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018;51(5):586-95. doi: 10.1002/uog.18961
- Goncalves MO, Siufi Neto J, Andres MP, et el. Systematic evaluation of endometriosis by transvaginal ultrasound can accurately replace diagnostic laparoscopy, mainly for deep and ovarian endometriosis. Hum Reprod. 2021;36(6):1492-500. doi: 10.1093/humrep/deab085
- Scardapane A, Lorusso F, Francavilla M, et al. Magnetic Resonance Colonography May Predict the Need for Bowel Resection in Colorectal Endometriosis. Biomed Res Int. 2017;2017:5981217. doi: 10.1155/2017/5981217
- Bazot M, Gasner A, Ballester M, Darai E. Value of thin-section oblique axial T2-weighted magnetic resonance images to assess uterosacral ligament endometriosis. Hum Reprod. 2011;26(2):346-35. doi: 10.1093/humrep/deq336
- Siegelman ES, Oliver ER. MR imaging of endometriosis: ten imaging pearls. Radiographics. 2012;32(6):1675-91. doi: 10.1148/rg.326125518
- Bielen D, Tomassetti C, Van Schoubroeck D, et al. IDEAL study: magnetic resonance imaging for suspected deep endometriosis assessment prior to laparoscopy is as reliable as radiological imaging as a complement to transvaginal ultrasonography. Ultrasound Obstet Gynecol. 2020;56(2):255-66. doi: 10.1002/uog.21868
- Bazot M, Gasner A, Lafont C, et al. Deep pelvic endometriosis: limited additional diagnostic value of postcontrast in comparison with conventional MR images. Eur J Radiol. 2011;80(3):e331-9. doi: 10.1016/j.ejrad.2010.12.006
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