OC16.07: Diagnostic performance of two‐dimensional and three dimensional ultrasonography and MR in the detection of deep endometriosis

To compare two-dimensional ultrasonography (2DUS), three dimensional ultrasonography (3DUS) and magnetic resonance (MR) in the detection of deep endometriosis. The study included 147 patients scheduled for surgery from January 2009 to December 2013 because of clinical suspicion of deep pelvic endometriosis. Modified transvaginal ultrasonography and MR was performed before surgery. Intestinal involvement, other posterior lesions (including rectovaginal septum and uterosacral ligaments) and bladder and uterine-vesical pouch involvement were considered. Also a 3D acquisition was performed and the volume was stored and evaluated after at least three months. The area under the receiver-operating characteristics curve for endometriosis of intestinal location were similar for 2DUS, 3DUS and MR (0.875, 0.91, 0.931 respectively; p > 0.05), for other posterior (0.807, 0.838, 0.858 respectively; p > 0.05) and for the anterior involvement (0.625; 0.716; 0.758, respectively; p > 0.05). The specificity, sensitivity, positive (LR+) and negative (LR-) likelihood ratios of 2DUS, 3DUS and MR, respectively, were 90% (84–97%), 93% (87–98%) and 94% (87–99%), 85% (76–94%),90% (82–97%) and 92% (86–98%), 8.6, 12 and 15 and 0.168, 0.15 and 0.08 for the intestinal involvement; 87% (79–94%),80% (71–89%) and 83% (74–91%), 75% (65–85%), 87% (80–95%) and 89% (81–96%), 5.7, 4 and 5.187 and 0.292, 0.15, 0.136 for other posterior locations; 98% (95–100%), 98% (95–100%) and 97% (94–99%), 27% (1–54%), 46% (16–75%) and 55% (25–84%), 12.3, 20 and 18.54 and 0.744, 0.558 and 0.468 for bladder and uterine-vesical pouch involvement. The diagnostic performance obtained in the present study by 3DUS is superior but not statistically significant in comparison with the 2DUS for all the localisations examined. Also the performance of 3DUS and MRI are similar. The present study is partially supported by Regione Autonoma della Sardegna.