Comparison of clinical and ultrasound examinations in assessing the parametria in patients with deep infiltrating endometriosis: a multicentre prospective study

Francesca Moro, F. Moro, Manuel Maria Ianieri, Alessandra De Cicco Nardone, Alessandra Nardone, Pietro Carfagna, P. Carfagna, Carfagna P, Mascilini F, Floriana Mascilini, F. Mascilini, Giuseppe Vizzielli, Anna Biasioli, Biasioli A, Giovanni Pontrelli, Pontrelli G, Bruna Anna Virgilio, Virgilio BA, B. Virgilio, Irene Ladisa, Ladisa I, Annunziata Carlea, Carlea A, Lo Turco A, Alice Lo Turco, Giuliana Beneduce, Martina Arcieri, Giulia Scaglione, Francesco Fanfani, Fanfani F, Giovanni Scambia, Scambia G, A. C. Testa, Testa AC, Antonia Carla Testa
Reproductive BioMedicine Online · 2023 · vol. 48(4) , pp. 103733 · doi:10.1016/j.rbmo.2023.103733 · PMID:38401251 · W4388906015
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This prospective study found that transvaginal ultrasound had good specificity but low sensitivity for anterior and lateral parametrial infiltration in endometriosis, while clinical examination showed good specificity for anterior and posterior parametria but low sensitivity for anterior and lateral parametria.

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Abstract

RESEARCH QUESTION: How do clinical rectovaginal examination and transvaginal ultrasound examination perform in the diagnosis of parametrial infiltration in patients with endometriosis? DESIGN: This was a multicentre prospective observational study. Patients with suspected deep endometriosis at clinical examination and/or at ultrasound evaluation and scheduled for surgery were included. Following multicentre multidisciplinary meetings, consensus was obtained on terms and methodology to define the parametrium at pelvic anatomy, ultrasound and surgery. Sensitivity, specificity, accuracy, and positive and negative likelihood ratios were calculated for clinical and ultrasound examinations with respect to surgery. RESULTS: In total, 195 women were selected for the present study and 164 were included in the analysis. Ultrasound examination had good to high specificity (>80%) for all parameters, except the left lateral parametrium (78.8%). The sensitivity of ultrasound examination was good to high for fixity of the right and left ovaries, uterosacral ligaments, retrocervix and rectovaginal space; and low for the anterior and lateral parametria, vagina, bladder and bowel. Clinical examination had good to high specificity for fixity of the left ovary, anterior parametrium, right uterosacral ligament, retrocervix and vagina; and low specificity for fixity of the right ovary, lateral parametrium, left uterosacral ligament and rectovaginal space. The sensitivity of clinical examination was good for the uterosacral ligaments and rectovaginal space, and low for the remaining parameters. CONCLUSION: Ultrasound examination provided good specificity for all the parameters, but sensitivity was low for the anterior and lateral parametria. Clinical examination provided good specificity for the anterior and posterior parametria, but sensitivity was low for the anterior and lateral parametria. Further prospective studies are needed to validate this methodology and confirm the results.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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.

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