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Accuracy of transvaginal sonography and rectal endoscopic sonography in the diagnosis of deep infiltrating endometriosis.
Ultrasound Obstet Gynecol 2007; 30(7):994-1001UO

Abstract

OBJECTIVES

To compare the accuracy of transvaginal sonography (TVS) and rectal endoscopic sonography (RES) for the diagnosis of deep infiltrating endometriosis (DIE), with respect to surgical and histological findings.

METHODS

This was a longitudinal study of 81 consecutive patients referred for surgical management of DIE, who underwent both TVS and RES preoperatively. The diagnostic criteria were identical for TVS and RES, and were based on visualization of hypoechoic areas in specific locations (uterosacral ligaments, vagina, rectovaginal septum and intestine). We calculated the sensitivity, specificity, predictive values and accuracy of TVS and RES for the diagnosis of DIE.

RESULTS

Endometriosis was confirmed histologically in 80/81 (98.7%) patients. Endometriomas and DIE were present in 43.2% and 97.5% of the women, respectively. For the diagnosis of DIE overall, TVS and RES, respectively, had a sensitivity of 87.3% and 74.7%, a positive predictive value of 98.6% and 98.3%, and an accuracy of 86.4% and 74%. For the diagnosis of uterosacral endometriosis, they had a sensitivity of 80.8% and 46.6%, a specificity of 75% and 50.0%, a positive predictive value of 96.7% and 89.5% and a negative predictive value of 30% and 9.3%. For the diagnosis of intestinal endometriosis, they had a sensitivity of 92.6% and 88.9%, a specificity of 100% and 92.6%, a positive predictive value of 100% and 96% and a negative predictive value of 87% and 80.6%.

CONCLUSION

TVS is apparently more accurate than is RES for predicting DIE in specific locations, and should thus be the first-line imaging technique in this setting.

Authors+Show Affiliations

Services de Radiologie, Hôpital Tenon, APHP, Paris, France. marc.bazot@tnn.aphp.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17992706

Citation

Bazot, M, et al. "Accuracy of Transvaginal Sonography and Rectal Endoscopic Sonography in the Diagnosis of Deep Infiltrating Endometriosis." Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, vol. 30, no. 7, 2007, pp. 994-1001.
Bazot M, Malzy P, Cortez A, et al. Accuracy of transvaginal sonography and rectal endoscopic sonography in the diagnosis of deep infiltrating endometriosis. Ultrasound Obstet Gynecol. 2007;30(7):994-1001.
Bazot, M., Malzy, P., Cortez, A., Roseau, G., Amouyal, P., & Daraï, E. (2007). Accuracy of transvaginal sonography and rectal endoscopic sonography in the diagnosis of deep infiltrating endometriosis. Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 30(7), pp. 994-1001.
Bazot M, et al. Accuracy of Transvaginal Sonography and Rectal Endoscopic Sonography in the Diagnosis of Deep Infiltrating Endometriosis. Ultrasound Obstet Gynecol. 2007;30(7):994-1001. PubMed PMID: 17992706.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Accuracy of transvaginal sonography and rectal endoscopic sonography in the diagnosis of deep infiltrating endometriosis. AU - Bazot,M, AU - Malzy,P, AU - Cortez,A, AU - Roseau,G, AU - Amouyal,P, AU - Daraï,E, PY - 2007/11/10/pubmed PY - 2008/5/20/medline PY - 2007/11/10/entrez SP - 994 EP - 1001 JF - Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology JO - Ultrasound Obstet Gynecol VL - 30 IS - 7 N2 - OBJECTIVES: To compare the accuracy of transvaginal sonography (TVS) and rectal endoscopic sonography (RES) for the diagnosis of deep infiltrating endometriosis (DIE), with respect to surgical and histological findings. METHODS: This was a longitudinal study of 81 consecutive patients referred for surgical management of DIE, who underwent both TVS and RES preoperatively. The diagnostic criteria were identical for TVS and RES, and were based on visualization of hypoechoic areas in specific locations (uterosacral ligaments, vagina, rectovaginal septum and intestine). We calculated the sensitivity, specificity, predictive values and accuracy of TVS and RES for the diagnosis of DIE. RESULTS: Endometriosis was confirmed histologically in 80/81 (98.7%) patients. Endometriomas and DIE were present in 43.2% and 97.5% of the women, respectively. For the diagnosis of DIE overall, TVS and RES, respectively, had a sensitivity of 87.3% and 74.7%, a positive predictive value of 98.6% and 98.3%, and an accuracy of 86.4% and 74%. For the diagnosis of uterosacral endometriosis, they had a sensitivity of 80.8% and 46.6%, a specificity of 75% and 50.0%, a positive predictive value of 96.7% and 89.5% and a negative predictive value of 30% and 9.3%. For the diagnosis of intestinal endometriosis, they had a sensitivity of 92.6% and 88.9%, a specificity of 100% and 92.6%, a positive predictive value of 100% and 96% and a negative predictive value of 87% and 80.6%. CONCLUSION: TVS is apparently more accurate than is RES for predicting DIE in specific locations, and should thus be the first-line imaging technique in this setting. SN - 0960-7692 UR - https://www.unboundmedicine.com/medline/citation/17992706/Accuracy_of_transvaginal_sonography_and_rectal_endoscopic_sonography_in_the_diagnosis_of_deep_infiltrating_endometriosis_ L2 - https://doi.org/10.1002/uog.4070 DB - PRIME DP - Unbound Medicine ER -