Deep Infiltrating Endometriosis (DIE)

Endometriosis is a chronic disease in which endometrial-like tissue grows outside the uterus and on other organs. Deep Infiltrating Endometriosis ( DIE) is defined by lesions that penetrate under the peritoneum by more than 5 mm and affects approximately 20% of patients with endometriosis. DIE nodules will not just superficially implant in the pelvis, but it will infiltrate into pelvic structures, mainly into the bowel, bladder, the vagina, and ligaments behind the uterus (uterosacral ligaments).

Ultrasound is an essential step in diagnosing DIE and guiding surgical decisions. It is easy and has no side effects, it can provide less invasive and first-line option to evaluate pelvic pain symptoms and discover endometriosis.

Which Ultrasound Scanner is the best for Deep Infiltration Endometriosis?

Using high-resolution Transvaginal Ultrasound Scanner CTC-3.1 is strongly suggested to our gynecologist clients. It can accurately diagnose endometriosis and allows the doctor to visualize not just the uterus and ovaries but also the bladder, the ligaments behind the uterus, the vaginal wall, and the bowel.

Ultrasound allows the gynecologist to map out the areas of involvement and thus predict the extent of disease. A transvaginal ultrasound will determine areas of increased pain and nonmobile, tethered internal pelvic organs. This will assist the gynecologist in counseling the patient and planning treatment, whether medical, nonpharmacologic, or surgical.

Some studies have found that transvaginal ultrasound had a specificity of 85 percent for all sites of deep infiltrating endometriosis measured. In some cases, the practitioner needed to use different techniques, such as bladder site tenderness-guided ultrasound, for greater detection. Water-contrast transvaginal ultrasound was more effective for detecting rectosigmoid endometriosis. With operator training and the right technique, however, ultrasound is a reliable method to diagnose DIE.

Furthermore, Endometriosis lesions on ultrasound look darker on ultrasound. When the rectum is empty, the views of the bowel are generally better since feces and gas in the bowel cause shadows on ultrasound. For this reason, some doctors prefer you to take a mild bowel preparation before the ultrasound when you have had a history of severe endometriosis or when you have significant bowel pain during your periods.

References: Deep Infiltrating Endometriosis, Deeply Infiltrative Endometriosis, Transvaginal Ultrasound for DIE,