What Does Endometriosis Look Like on Ultrasound
What Does Endometriosis Look Like on Ultrasound Endometriosis is a chronic condition where tissue similar to the uterine lining, called endometrial tissue, grows outside the uterus, causing pain, inflammation, and sometimes fertility issues. Diagnosing endometriosis can be challenging because its symptoms often overlap with other conditions. While laparoscopy remains the gold standard for definitive diagnosis, ultrasound imaging has become an essential non-invasive tool in identifying signs suggestive of this complex disorder.
On ultrasound, endometriosis does not have a single characteristic appearance but can present through various features depending on the location and severity of the lesions. The most common and recognizable ultrasound finding relates to endometriomas, often referred to as “chocolate cysts.” These are ovarian cysts filled with thick, dark, degenerated blood products. On ultrasound, endometriomas typically appear as well-defined, round or oval ovarian cysts with homogeneous, low-level internal echoes, giving a “ground-glass” appearance. This distinctive feature helps differentiate them from other ovarian cysts, such as functional cysts or hemorrhagic cysts. What Does Endometriosis Look Like on Ultrasound
What Does Endometriosis Look Like on Ultrasound Beyond endometriomas, ultrasound can also identify other signs indicative of pelvic endometriosis. For example, deep infiltrating endometriosis (DIE) involves lesions that penetrate beyond the surface of pelvic organs. These may appear as hypoechoic (darker) nodules or thickening of the uterosacral ligaments, rectovaginal septum, or bowel walls. Such nodules often have irregular borders and may demonstrate increased vascularity on Doppler imaging, which can aid in their identification.
What Does Endometriosis Look Like on Ultrasound In some cases, endometrial implants on the peritoneal surfaces are too small to be directly visualized via ultrasound. However, secondary signs, like localized pelvic adhesions or distortion of pelvic anatomy, may suggest their presence. For example, the obliteration of the pouch of Douglas or an irregular uterine contour can be clues pointing toward endometriosis.
It’s important to note that ultrasound sensitivity varies based on the experience of the operator and the equipment used. While it is highly effective in detecting ovarian endometriomas, it may be less sensitive for superficial peritoneal endometriosis or deep infiltrating lesions that are not associated with cyst formation. Advanced techniques, such as transvaginal ultrasound with bowel preparation or 3D ultrasound, can improve visualization and diagnostic accuracy. What Does Endometriosis Look Like on Ultrasound
In clinical practice, ultrasound is often used alongside patient history and physical examinations to build a comprehensive picture. When ultrasound findings suggest endometriosis, further diagnostic procedures like laparoscopy are usually recommended to confirm the diagnosis and plan appropriate treatment.
In summary, on ultrasound, endometriosis manifests primarily through ovarian endometriomas with characteristic ground-glass cysts and, in some cases, through visualized nodules or thickening of pelvic structures associated with deep infiltrating disease. While ultrasound offers valuable insights, it is part of a broader diagnostic approach that may include other imaging modalities and surgical confirmation. What Does Endometriosis Look Like on Ultrasound
