Comparison Between Sonography-Based and Surgical Evaluation of Endometriotic Lesions Using the #Enzian Classification – A Retrospective Data Analysis

A. Di Giovanni, Alessandra Di Giovanni, Eliana Montanari, Gernot Hudelist, Mario Malzoni, J. Keckstein, Joerg Keckstein
Ultraschall in der Medizin (Stuttgart, Germany : 1980) · 2022 · vol. 44(03) , pp. 290–298 · doi:10.1055/a-1713-3573 · PMID:35345051 · W4220853307
article OA: closed CC0 ⤵ 24 in-corpus citations
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Transvaginal sonography accurately assesses the location and size of deep endometriosis lesions within Enzian compartments compared to surgical findings, providing a detailed preoperative description.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective study analyzed 93 women who underwent preoperative transvaginal sonography (TVS) and subsequent surgery for deep endometriosis in 2019 at a tertiary endometriosis center, comparing lesion location and size across #Enzian compartments with intraoperative assessment. The highest exact concordance was for compartment C (rectum) at 74%, rising to 87% when a maximum 3 mm TVS measurement tolerance was applied; compartments B and A had somewhat lower exact concordance, while compartment O showed high concordance and compartment T was most reliable for slight (T1) and severe adhesions (T3). The paper reports few missed lesions and generally high diagnostic performance, with sensitivity of 100% across most compartments except A/B left and FB, and specificity varying by compartment (e.g., 70% for B left). This paper is centrally about endometriosis — it compares TVS versus surgical extent using the #Enzian classification for deep endometriotic lesions.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

PURPOSE: To compare the location and sizes of deep endometriosis (DE) lesions evaluated by preoperative transvaginal sonography (TVS) in different #Enzian compartments with intraoperatively assessed DE location and size. MATERIALS AND METHODS: Retrospective data analysis of 93 women undergoing TVS and surgery for DE in 2019 at a tertiary referral center for endometriosis. RESULTS: #Enzian compartment C (rectum) showed the highest rate of exact concordance with 74% of cases, which increased to 87% when a tolerance margin of a maximum of 3mm for TVS measurements was taken into account. For compartment B (uterosacral ligaments, parametria) and compartment A (vagina, rectovaginal space), the rates of exact concordance were slightly lower. In compartment O (ovary), high exact concordance rates similar to those observed for compartment C were observed. In compartment T (tubo-ovarian unit), most reliable estimations were seen for slight (TVS T1) and severe adhesions (TVS T3). There were only a few cases of missed lesions as well as false positives on TVS: Sensitivity was 100% for all compartments except for A and B left (97%) and FB (urinary bladder, 86%); specificity was 100% for FB, FI (other intestinal locations), FU (ureters) and O right, 86%-98% for A, B right, C, O left and FO (other extragenital lesions) and 70% for B left. CONCLUSION: The preoperative evaluation of the location and size of DE lesions by TVS in different #Enzian compartments is accurate, providing a detailed presurgical description of the extent of ovarian and deep endometriosis and associated minor or severe adhesions.

My notes (saved in your browser only)

Outcome instruments

Enzian

Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Female Female Female Humans Humans Humans Rectum Rectum Rectum Rectum Retrospective Studies Retrospective Studies Retrospective Studies Sensitivity and Specificity

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (7)

Cited by (25)

Source provenance

europepmc
last seen: 2026-06-16T06:07:01.518242+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-26T00:34:54.835117+00:00
unpaywall
last seen: 2026-06-16T06:25:30.133384+00:00
License: CC0 · commercial use OK