title: Potential role of strain elastography for detection of the extent of large-scar endometriosis.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the clinical value of strain elastography for detection of the lesion extent of large-scar endometriosis and compare it to conventional sonography and magnetic resonance imaging (MRI).
  
  
  METHODS
  Eight patients suspected of having large-scar endometriosis underwent transabdominal sonography, strain elastography, and MRI. The mass was located and assessed for its size, imaging appearance, and, especially, widest boundary and vertical extent. After wide surgical excision and pathologic diagnosis, lesions in the central area shown on conventional sonography and the extended area shown on strain elastography underwent immunohistochemical examination.
  
  
  RESULTS
  Nodules were always deep in the subcutaneous plane, in contact with the fascia or muscle. Horizontally, the mean lesion size shown on conventional sonography was mainly consistent with the size on MRI in all cases, but it was obviously smaller on sonography than on strain elastography in 7 cases. Vertically, the lesion depth was mainly consistent with the depth on MRI in 7 cases, but it was more infiltrative on strain elastography in 6 cases. The vertical and horizontal infiltration scales of the postoperative specimens were consistent with strain elastography in all cases. All 8 patients showed strong collagen type I expression in the central area of the lesions; 6 patients showed strong collagen type I expression and the other 2 showed moderate expression in the extended area.
  
  
  CONCLUSIONS
  Strain elastography can elevate the diagnostic accuracy of large-scar endometriosis, the extent of which may be evaluated insufficiently by transabdominal sonography and MRI.
authors: Department of Ultrasound, Obstetrics and Gynecology Hospital, Fudan University, 128 Shen Yang Rd, 200090 Shanghai, China.
authors: Meng
authors: M
authors: Xie
authors: Xuyin
authors: X
authors: Zhang
authors: Jia
authors: J
authors: Zhan
authors: Yunyun
authors: Y
authors: Ren
authors: Wenping
authors: W
authors: Wang
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000328:Adult; D002921:Cicatrix / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004715:Endometriosis / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: abdominal wall endometriosis; sonography; strain elastography