Importance of Transvaginal Ultrasound Applying Elastography for Identifying Deep Infiltrating Endometriosis - A Feasibility Study

Purpose: To evaluate the presence of a lesion indicative of endometriosis with transvaginal elastography. Materials and Methods: Transvaginal ultrasound and clinical examination were carried out in 48 women with clinical symptoms indicative of endometriosis. In 31 cases strain values were measured at two regions of interest (ROIs) in the Douglas's cul-de-sac during a cycle of compression and decompression with a vaginal probe. Results: A significant difference was found for the ratio of the ROI measuring points in the Douglas' cul-de-sacs of women with a palpable nodule in examination compared to women without a palpable nodule (p = 0.002). Conclusion: The ratio of strain values between two ROIs in the Douglas's cul-de-sac is associated with the presence of an endometriotic lesion. In the future, these findings could allow for a more detailed pre-surgical evaluation and possibly serve as a novel diagnostic tool for predicting deep infiltrating endometriosis.