Endometriosis is a prevalent and potentially debilitating condition that mostly affects individuals of reproductive age, and often has a substantial diagnostic delay. US is usually the first-line imaging modality used when patients report chronic pelvic pain or have issues of infertility, both common symptoms of endometriosis. Other than the visualization of an endometrioma, sonologists frequently do not appreciate endometriosis on routine transvaginal US images. Given a substantial body of literature describing techniques to depict endometriosis at US, the Society of Radiologists in Ultrasound convened a multidisciplinary panel of experts to make recommendations aimed at improving the screening process for endometriosis. The panel was composed of experts in the imaging and management of endometriosis, including radiologists, sonographers, gynecologists, reproductive endocrinologists, and minimally invasive gynecologic surgeons. A comprehensive literature review combined with a modified Delphi technique achieved a consensus. This statement defines the targeted screening population, describes techniques for augmenting pelvic US, establishes direct and indirect observations for endometriosis at US, creates an observational grading and reporting system, and makes recommendations for additional imaging and patient management. The panel recommends transvaginal US of the posterior compartment, observation of the relative positioning of the uterus and ovaries, and the uterine sliding sign maneuver to improve the detection of endometriosis. These additional techniques can be performed in 5 minutes or less and could ultimately decrease the delay of an endometriosis diagnosis in at-risk patients.

© RSNA, 2024

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子宫内膜异位症是一种普遍存在且可能使人衰弱的疾病，主要影响育龄个体，并且往往会造成严重的诊断延迟。当患者报告慢性盆腔疼痛或有不孕问题（子宫内膜异位症的常见症状）时，超声通常是首选的影像学检查方式。除了子宫内膜异位症的可视化之外，超声医师经常无法在常规经阴道超声图像上识别子宫内膜异位症。鉴于美国有大量描述子宫内膜异位症技术的文献，超声放射科医生协会召集了一个多学科专家小组，提出旨在改进子宫内膜异位症筛查过程的建议。该小组由子宫内膜异位症影像和治疗专家组成，包括放射科医生、超声医师、妇科医生、生殖内分泌科医生和微创妇科外科医生。综合文献综述结合改进的德尔菲技术达成了共识。该声明定义了目标筛查人群，描述了增强盆腔超声的技术，在超声中建立了对子宫内膜异位症的直接和间接观察，创建了观察分级和报告系统，并提出了额外成像和患者管理的建议。专家组建议对后室进行经阴道超声检查，观察子宫和卵巢的相对位置，以及子宫滑动征操作，以提高子宫内膜异位症的检出率。这些附加技术可以在 5 分钟或更短的时间内完成，最终可以减少高危患者子宫内膜异位症诊断的延迟。

 © 北美放射学会，2024

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