Imaging diagnosis of deep infiltrating endometriosis

Abstract

Deep infiltrating endometriosis (DIE) is defined as the in­fil­tra­tion of endometriotic implants deeper than 5 mm from the peritoneal surface. When the lesions infiltrate the mus­cu­laris propria layer of the rectum or sigmoid, we talk about intestinal endometriosis (IE), the most common form of extragenital endometriosis, which affects, according to va­rious studies, up to 37% of women with endometriosis. En­do­me­trio­sis is an underdiagnosed condition mainly due to the lack of cheap and noninvasive diagnostic tools. Al­though transvaginal ultrasonography (TVUS) is considered the first line in the imaging diagnosis of endometriosis, so­no­va­gi­no­gra­phy, endorectal ultrasonography (ERUS), mag­ne­tic resonance imaging (MRI) and coloscan are becoming in­creas­ingly important in the evaluation of patients with DIE, completing the preoperative assessment of endo­me­trio­tic lesions, an assessment that needs to be done as ac­cu­rate­ly as possible, both for the purpose of counseling pa­tients and choosing the optimal therapeutic approach.