Endometriosis Clinical Trial
Official title:
Assessment of Pelvic Endometriosis: Correlation of US and MRI With Laparoscopic Findings
Endometriosis is classically defined as the presence of endometrial glands and stroma outside
the uterine cavity and its musculature.
The definition of deep endometriosis is based on anatomic assumptions that may prove
erroneous.
In fact, the term '' deep endometriosis '' should be reserved for lesions in the
retroperitoneal tissue. For practical purposes, several reports included in the so-called
deep endometriosis the infiltrative forms that involve vital structures such as the bowel,
ureters, and bladder, as well as forms such as many rectovaginal lesions. For the term
''deep'' to apply, there should be ectopic endometrial tissue penetrating the peritoneum more
than 5 mm in depth.
The ectopic endometrium responds to hormonal stimulation with various degrees of cyclic
hemorrhage which result in suggestive symptoms and appearances.
A common symptom is infertility. Pelvic pain is a frequent complaint among patients with
endometriosis. Such pain generally manifests as secondary dysmenorrhea, worsening primary
dysmenorrhea, dyspareunia, or even noncyclic lower abdominal pain and backaches. The pain may
be site-specific when endometriosis is found in unusual locations outside the pelvis.
Diagnosis Physical examination and laparoscopic exploration may not allow diagnosis or
prediction of the extension of deep pelvic endometriosis, especially in pelvic
retroperitoneal sites.
Transvaginal sonography is recommended for diagnosis of endometriomas and endometriosis of
the bladder but its value for assessment of superficial peritoneal lesions, ovarian foci, and
deep pelvic endometriosis is uncertain.
MR imaging is now commonly used for diagnosis of endometriosis and provides a tremendous
advantage over other methods of investigation, owing to the possibility of making a complete
survey of the anterior and posterior compartments of the pelvis at one time.
MRI is becoming a mainstay of preoperative diagnosis, in particular for diagnosis deep
infiltrating endometriosis.
A prospective study including 30 Female patients of reproductive who were previously
clinically diagnosed to have endometriotic lesions. these will be sent to our department to
identify the extent of the lesions and clarify the exact location for proper treatment.
All patients were evaluated with ultrasound and MRI. the sensitivity, specificity and
diagnostic accuracy for both examination were calculated.
Transvaginal ultrasound and MRI will be done in our Radiology department to all patients
after signing an informed consent to be enrolled in the study.
All our imaging results were finally compared to the laparoscopic results which are our gold
standard.
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