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Comparison of transvaginal sonography and double-contrast barium enema for diagnosing deep infiltrating endometriosis of the posterior compartment.
Ultrasound Obstet Gynecol 2011; 38(4):466-71UO

Abstract

OBJECTIVES

To compare the diagnostic accuracy of transvaginal sonography (TVS) and double-contrast barium enema (DCBE) in the preoperative detection of deep infiltrating endometriosis (DIE) of the posterior compartment.

METHODS

This was a prospective study of 69 consecutive patients with results of pelvic examination or symptoms suggestive of DIE of the posterior compartment. TVS and DCBE were performed before surgery by two groups of physicians specialized in endometriosis, each blinded to the results of the other technique. Imaging data were compared with histopathologic analysis of the resected specimen (gold standard). Sensitivity, specificity, positive and negative predictive values and test accuracies were calculated for both imaging modalities.

RESULTS

Sixty seven of the 69 women had a nodule of DIE confirmed at laparoscopy and histopathologic examination. TVS diagnosed DIE in 57 (85%) of these patients, while DCBE revealed the presence of the lesion in 24 (36%) women. For the diagnosis of posterior DIE, TVS and DCBE had, respectively, a sensitivity of 85% and 36%, specificity of 100% and 100%, positive predictive value of 100% and 100%, negative predictive value of 17% and 4% and accuracy of 85.5% and 38%. In patients with pure bowel DIE the sensitivity was 91% and 43%, specificity was 100% and 100%, positive predictive value was 100% and 100%, negative predictive value was 29% and 6% and accuracy was 91% and 45%, respectively.

CONCLUSIONS

TVS has a much higher sensitivity than does DCBE in detecting the presence of posterior DIE and should thus be regarded as the imaging modality of choice when there is clinical suspicion of the disease.

Authors+Show Affiliations

Gynecology and Reproductive Medicine Unit, Department of Obstetrics and Gynecology, S. Orsola-Malpighi Hospital, Bologna, Italy. luca.savelli@aosp.bo.itNo affiliation info availableNo 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

21656868

Citation

Savelli, L, et al. "Comparison of Transvaginal Sonography and Double-contrast Barium Enema for Diagnosing Deep Infiltrating Endometriosis of the Posterior Compartment." Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, vol. 38, no. 4, 2011, pp. 466-71.
Savelli L, Manuzzi L, Coe M, et al. Comparison of transvaginal sonography and double-contrast barium enema for diagnosing deep infiltrating endometriosis of the posterior compartment. Ultrasound Obstet Gynecol. 2011;38(4):466-71.
Savelli, L., Manuzzi, L., Coe, M., Mabrouk, M., Di Donato, N., Venturoli, S., & Seracchioli, R. (2011). Comparison of transvaginal sonography and double-contrast barium enema for diagnosing deep infiltrating endometriosis of the posterior compartment. Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 38(4), pp. 466-71. doi:10.1002/uog.9072.
Savelli L, et al. Comparison of Transvaginal Sonography and Double-contrast Barium Enema for Diagnosing Deep Infiltrating Endometriosis of the Posterior Compartment. Ultrasound Obstet Gynecol. 2011;38(4):466-71. PubMed PMID: 21656868.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of transvaginal sonography and double-contrast barium enema for diagnosing deep infiltrating endometriosis of the posterior compartment. AU - Savelli,L, AU - Manuzzi,L, AU - Coe,M, AU - Mabrouk,M, AU - Di Donato,N, AU - Venturoli,S, AU - Seracchioli,R, PY - 2011/6/10/entrez PY - 2011/6/10/pubmed PY - 2011/12/22/medline SP - 466 EP - 71 JF - Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology JO - Ultrasound Obstet Gynecol VL - 38 IS - 4 N2 - OBJECTIVES: To compare the diagnostic accuracy of transvaginal sonography (TVS) and double-contrast barium enema (DCBE) in the preoperative detection of deep infiltrating endometriosis (DIE) of the posterior compartment. METHODS: This was a prospective study of 69 consecutive patients with results of pelvic examination or symptoms suggestive of DIE of the posterior compartment. TVS and DCBE were performed before surgery by two groups of physicians specialized in endometriosis, each blinded to the results of the other technique. Imaging data were compared with histopathologic analysis of the resected specimen (gold standard). Sensitivity, specificity, positive and negative predictive values and test accuracies were calculated for both imaging modalities. RESULTS: Sixty seven of the 69 women had a nodule of DIE confirmed at laparoscopy and histopathologic examination. TVS diagnosed DIE in 57 (85%) of these patients, while DCBE revealed the presence of the lesion in 24 (36%) women. For the diagnosis of posterior DIE, TVS and DCBE had, respectively, a sensitivity of 85% and 36%, specificity of 100% and 100%, positive predictive value of 100% and 100%, negative predictive value of 17% and 4% and accuracy of 85.5% and 38%. In patients with pure bowel DIE the sensitivity was 91% and 43%, specificity was 100% and 100%, positive predictive value was 100% and 100%, negative predictive value was 29% and 6% and accuracy was 91% and 45%, respectively. CONCLUSIONS: TVS has a much higher sensitivity than does DCBE in detecting the presence of posterior DIE and should thus be regarded as the imaging modality of choice when there is clinical suspicion of the disease. SN - 1469-0705 UR - https://www.unboundmedicine.com/medline/citation/21656868/Comparison_of_transvaginal_sonography_and_double_contrast_barium_enema_for_diagnosing_deep_infiltrating_endometriosis_of_the_posterior_compartment_ L2 - https://doi.org/10.1002/uog.9072 DB - PRIME DP - Unbound Medicine ER -