Extended transvaginal sonography in deep infiltrating endometriosis: use of bowel preparation and an acoustic window with intravaginal gel: preliminary results
León M1 Vaccaro H, Alcázar JL, Martinez J, Gutierrez J, Amor F, Irurra A, Sovino H. 1 Department of Obstetrics and Gynecology, Medical School, Clinica Universidad de Navarra
Magazine: Journal of ultrasound in Medicine
Date: Feb 3, 2014Gynaecology and Obstetrics [SP]
OBJECTIVES: the purpose of this study was to assess the diagnostic performance of extended transvaginal sonography for diagnosing deep infiltrating endometriosis.
METHODS: A prospective study was conducted comprising 51 women (mean age, 32.9 years; range, 23-43 years) with suspected deep infiltrating endometriosis based on clinical symptoms. All women underwent extended transvaginal sonography, which included assessment of 2 pelvic compartments (anterior compartment: bladder and distal ureters; and posterior compartment: posterior vaginal fornix, retrocervical area, pouch of Douglas, and rectosigmoid). The sliding sign for detecting pouch of Douglas obliteration was also assessed. All patients received bowel preparation before sonographic examinations. A single examiner performed all examinations. All women underwent laparoscopic surgery, and histologic confirmation of endometriosis was done. The sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were calculated.
RESULTS: Some women had more than 1 lesion, giving a total of 55 histologically confirmed lesions (rectosigmoid, n = 13; vagina, n = 5; retrocervical, n = 32; bladder, n = 5). The sensitivity, specificity, and LR+ for rectosigmoid involvement were 100%, 93%, and 14.0, respectively. The sensitivity, specificity, LR+, and LR- for vaginal involvement were 60%, 98%, 30.0, and 0.41. The sensitivity, specificity, LR+, and LR- for retrocervical involvement were 84%, 96%, 19.4, and 0.16. The sensitivity, specificity, and LR- for bladder involvement were 20%, 100%, and 0.80. The sensitivity, specificity, LR+, and LR- of the sliding sign for diagnosing pouch of Douglas obliteration were 89%, 92%, 10.7, and 0.12.
CONCLUSIONS: Except for bladder involvement, extended transvaginal sonography has good diagnostic performance for deep infiltrating endometriosis.
CITATION J Ultrasound Med. 2014 Feb;33(2):315-21. doi: 10.7863/ultra.33.2.315.
you mayBE INTERESTED
The Clínica is the greater private hospital with technological equipment of Spain, all in a single center.
The professionals of the Clínica perform continuous research and training, always to the benefit of the patient.
Learn why we are different from other healthcare centers. Quality, speed, comfort and results.