Fusion US/MR imaging in the evaluation of deep infiltrating endometriosisJul 19, 2019
Fusion US/MR imaging has an important role in the evaluation of deep infiltrating endometriosis.
- Fusion US/MR imaging, a relatively new technique, is superior to ultrasonography in terms of nerve visualization for endometriosis surgery.
- Postoperative urinary retention can be prevented in case the pelvic nerves can be well-visualized by imaging and spared during surgery in patients with deep infiltrating endometriosis.
What's done here:
- The importance of fusion US/MR imaging in the assessment of deep infiltrating endometriosis over a case of parametrial nodule entrapping the left hypogastric nerve is discussed.
- In patients with deep infiltrating endometriosis, fusion US/MR imaging may be useful to verify nerve involvement, to optimize preoperative counseling and surgery planning.
Scioscia M. et al., from Italy presented a case of a large deep infiltrating nodule of the uterosacral ligament and discussed the importance of a relatively new technique, fusion US/MR imaging in their article.
The article containing a video of dynamic evaluation using MR/ultrasound fusion technique and at laparoscopy has been published in the "Journal of Minimally Invasive Gynecology".
The lesion deepened into the parametrium and medially infiltrates the rectum. MR/ultrasound fusion imaging verified the entrapment of the left hypogastric nerve in the parametrial nodule.
The surgeons removed all lesions with left-posterior parametrectomy with hypogastric nerve transection and segmental bowel resection. It is recommended to be conservative on one side in case of bilateral deep hypogastric nerve entrapment to prevent complete bladder denervation.
According to the authors, fusion US/MR imaging may be useful to verify nerve involvement, to optimize preoperative counseling and surgery planning in patients with deep infiltrating endometriosis.
Research Source: https://www.ncbi.nlm.nih.gov/pubmed/31301470
endometriosis hypogastric nerve laparoscopy surgery ultrasound laparoscopy endometriosis parametrium uterosacral ligament nerve involvement counseling