Surgical presentation of endometriosis can be differentiated using soft markers on transvaginal ultrasound

Objectives The non-invasive diagnosis of endometriosis by routine ultrasound is a challenge in the management of patients with this disease.This study sought to determine which clinical factors and markers on endometriosis specific US could differentiate the surgical presentations of deep endometriosis-(DeepEndo), superficial endometriosis-(SupEndo), and no endometriosis-(NoEndo). Methods At a tertiary care centre, two expert imagers performed 505 advanced endometriosis transvaginal ultrasounds (AETUs) between January 2014 and October 2016. We included 143 patients who had an AETU prior to their endometriosis related surgical procedure. Information on demographics, clinical presentation, and AETU findings were collected by retrospective chart review. Patients were classified based on surgical presentation. Between group differences were evaluated using chi-square, one-way ANOVAs and Kruskal-Wallis tests at p Results Of the 88 cases reviewed thus far, 41 were DeepEndo, 22 were SupEndo, and 25 were NoEndo. No associations in clinical presentation (symptoms and nodularity) were observed between groups. DeepEndo had a significantly lower BMI (24.4±5.3 kg/m2) than SupEndo (29.0± 7.2; p=0.010). AETUs were more likely to suspect endometrioma (p Conclusions Significant associations between AETU and surgical presentation were observed. Soft markers on US can be incorporated into the routine US assessment, thus improving diagnosis and treatment efficacy for patients with endometriosis.