Deep Infiltrating Endometriosis Scan
In the hands of a specialised sonographer, ultrasound is a powerful tool for identifying certain forms of endometriosis. It can guide diagnosis and management and is often the first step before considering more invasive procedures.
What is endometriosis?
Endometriosis is a chronic condition where endometrial tissue (the lining of the uterus) grows outside the uterus, commonly on the ovaries, fallopian tubes, bowel and pelvic lining. This ectopic tissue responds to hormonal changes in the menstrual cycle or can be reactivated with the use of MHT (menopausal hormonal treatment), leading to inflammation, scarring, and often severe pelvic pain, infertility or both.
Some women with endometriosis may not experience any symptoms at all.
Some women with endometriosis may not experience any symptoms at all.
Symptoms may include:
- Pain during periods (dysmenorrhoea)
- Pain with sexual intercourse (dyspareunia)
- Pain on defecation with periods (dyschezia)
- Chronic pelvic pain
- Abnormal bleeding
- Infertility
Endometriosis on ultrasound
Transvaginal pelvic ultrasound can prove useful for detecting endometriomas, typically within the ovaries. These can appear as:
- Homogenous, hypoechoic cysts within the ovarian tissue (dark areas on the scan)
- low level internal echoes and no obvious vascularity.
Deep Infiltrating Endometriosis (DIE)
Deep Infiltrating Endometriosis (DIE) may involve the bowel, supporting uterine ligaments, bladder and other pelvic organs.
A specialised (DIE) scan is conducted by a highly trained sonographer and typically combines transabdominal and transvaginal ultrasound for optimal assessment of the pelvic organs.
A specialised (DIE) scan is conducted by a highly trained sonographer and typically combines transabdominal and transvaginal ultrasound for optimal assessment of the pelvic organs.
Whilst more challenging to detect, our skilled sonographers may identify:
- Nodules or thickening of tissue adjacent to the uterus and ovaries
- Reduced mobility of the ovaries, which can be suggestive of scar tissue
- Altered uterine appearance, position or movement
- A ‘stuck’ pelvis, where pathology results in tissues of the pelvis becoming fixed and immobile.
Before your ultrasound
Bowel contents can sometimes limit views of the pelvis. Preparing the bowel before your scan can help provide clearer vaginal ultrasound images and allow for a more thorough assessment.
The night before your scan you will be required to take a mild laxative, making it easier to empty the bowel. Your doctor will give you clear instructions. Some people may experience some cramping with this.
The night before your scan you will be required to take a mild laxative, making it easier to empty the bowel. Your doctor will give you clear instructions. Some people may experience some cramping with this.
Results and next steps
It is important that your symptoms, your referring doctor’s questions, and the ultrasound findings are carefully reviewed by an experienced sonologist or radiologist. This ensures we provide the most accurate summary of your scan.
Your results are sent directly to your GP or referring specialist, who knows you best and will discuss them with you at your follow-up appointment. At this appointment, you may also be provided with a copy of your ultrasound report.
Your results are sent directly to your GP or referring specialist, who knows you best and will discuss them with you at your follow-up appointment. At this appointment, you may also be provided with a copy of your ultrasound report.
If you have further questions on ultrasound for Deep Infiltrating Endometriosis or would like to make an appointment, please contact the Ultrasound North team.
