Predictive Value of Transvaginal Ultrasound in Diagnosis of Endometriosis: A Three Year Study

Background: To assess the predictive value of various transvaginal sonography findings in characterizing endometriosis. IJ Radiology Author(s): 1MD, Radiologist, Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran 2BSC, Department of Epidemiology and Reproductive Health, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran 3PhD, Department of Epidemiology and reproductive health, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran Published online:Apr 12, 2017 Article type:Abstract Received:Dec 20, 2016 Accepted:Feb 07, 2017 How to Cite:Niknejadi M, Javam M, Chehrazi M. Predictive Value of Transvaginal Ultrasound in Diagnosis of Endometriosis: A Three Year Study. I J Radiol. 2017;14(Special Issue):e48033. doi: https://doi.org/10.5812/iranjradiol.48033 To assess the predictive value of various transvaginal sonography findings in characterizing endometriosis. This prospective investigation was conducted at Royan Institute, Tehran, Iran, from April 2010 till March 2013. All infertile women presenting with clinical symptoms of endometriosis, who were booked for laparoscopy, underwent a preoperative trasvaginal sonography by an expert radiologist. Endometriosis was diagnosed on TVS according to detecting one or more of following findings: echogenic points on serosal surface of the ovaries, ovarian endometrioma and signs of pelvic adhesion (blurred ovary margins, fixation of ovaries, deviation of ovaries or decreased distance between them). A logistic regression analysis was performed to identify prognostic factors in detection of presence of endometriosis. Each parameter was entered sequentially into the model based on hosmer-lemeshow algorithm. Values were calculated by Stata12 software regarding laparoscopy as gold standard. Totally, 101women were evaluated during the study. Endometriosis was present at laparoscopy in 58 patients. Mean age and the duration of infertility were calculated 30.78 4.79 and 4.2 2.91 years respectively. Frequencies of each sonographic finding were as follow: echogenic points (%31.68), ovarian endometrioma (%30.69), blurred ovary margin (%7.92), fixation of ovaries (%15.9), deviation of ovaries (%21.8), and decreased distance between ovaries (%8.9). As derived by logistic regression analysis, detection of ovarian endometrioma, fixation of ovaries and ovarian deviation strongly predicts endometriosis (odds ratio of 42.27, 46.89 and 14.78 respectively). Our study demonstrated that TVS has a reliable predictive value in diagnosis of endometriosis. Ovarian endometrioma, deviation of ovaries and ovarian fixation can be used as important criteria for radiologists and gynecologists. Full text is available in PDF © 2017, Author(s). This open-access article is available under the Creative Commons Attribution 4.0 (CC BY 4.0) International License (https://creativecommons.org/licenses/by/4.0/), which allows for unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited. 28 Feb 2014 Maryam Niknejadi, Ashraf Moini, Zohreh Rashidi, Fatemeh Niknejad, Hadieh Haghighi, Reza Salmanyazdi ,et al.Niknejadi M, Moini A, Rashidi Z, Niknejad F, Haghighi H, et al. Ultrasound in the Diagnosis of Endometriosis. I J Radiol. 2014;11(30th Iranian Congress of Radiology):e21412. doi: https://doi.org/10.5812/iranjradiol.21412 17 Sep 2012 Maryam Niknejadi, Hadieh Haghighi, Firoozeh Ahmadi, Fatemeh Niknejad, Mohammad Chehrazi, Ahmad Vosough ,et al.Niknejadi M, Haghighi H, Ahmadi F, Niknejad F, Chehrazi M, et al. Diagnostic Accuracy of Transvaginal Sonography in the Detection of Uterine Abnormalities in Infertile Women. I J Radiol. 2012;9(3):e79461. doi: 20 Jan 2023 Nahid Sadighi, Behnaz Moradi, Masoumeh Gity, Behnaz Boroujerdirad, Fateme Davari-tanha, Reza Daneshvar ,et al.Sadighi N, Moradi B, Gity M, Boroujerdirad B, Davari-tanha F, et al. Diagnostic Accuracy of Transvaginal Sonography for Deeply Infiltrating Endometriosis and Pouch of Douglas Obliteration in the Presence or Absence of Ovarian Endometrioma. I J Radiol. 2022;19(4):e127068. doi: https://doi.org/10.5812/iranjradiol-127068 12 Apr 2017 Firoozeh Ahmadi, Maryam Javam, Fatemeh Niknejad Ahmadi F, Javam M, Niknejad F. Efficacy of Three-Dimensional Transvaginal Sonography in Diagnosis of Uterine Cavity Abnormalities Among Infertile Women: A Cross-Sectional Study. I J Radiol. 2017;14(Special Issue):e48026. doi: https://doi.org/10.5812/iranjradiol.48026 29 May 2013 Elham Shobairi, Nasrin Jalilian, Mansour Rezaie, Sara Behafarid Shobairi E, Jalilian N, Rezaie M, Behafarid S. Diagnostic index of doppler sonography in ectopic pregnancy. 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