Correlation between ultrasound findings and laparoscopy in prediction of deep infiltrating endometriosis (DIE)

Melinda Pattanasri, Ades A, A. E. Ades, Alex Ades, Nanayakkara P, Pav Nanayakkara
The Australian & New Zealand journal of obstetrics & gynaecology · 2020 · vol. 60(6) , pp. 946–951 · doi:10.1111/ajo.13242 · PMID:32895927 · W3084148540
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This study found specialist transvaginal ultrasound accurately predicted deep infiltrating endometriosis in most locations, while community ultrasound was largely inaccurate except for ovarian endometriomas and adhesions.

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Abstract

BACKGROUND: Detailed pre-operative description of endometriotic lesions by non-invasive methods is an important tool for accurate diagnosis and effective treatment of the disease. Transvaginal ultrasound (TVUS) is a sensitive method for diagnosis of deep infiltrating endometriosis (DIE); however, it is highly operator-dependent and consistent results require adequately trained and experienced clinicians. AIMS: The aim of the study is to assess the accuracy of TVUS in predicting DIE by comparing it with laparoscopic findings. We also compared US done in the community by general radiologists with examinations done by specialist gynaecologists. MATERIALS AND METHODS: A retrospective cohort study of patients who underwent laparoscopy for excision of possible endometriosis between July 2014 to February 2019 who had a TVUS prior to laparoscopy. RESULTS: A total of 119 patients were included. TVUS was shown to be useful in detecting all but bladder DIE. Community TVUS was no better than chance at identifying most DIE (area under the curve (AUC) of 0.48-0.60) except in the detection of ovarian endometriomas and adhesions (AUC = 0.84). Specialist TVUS correctly identified most DIE with greatest utility for DIE in rectosigmoid (AUC = 0.85, P < 0.000), followed by pouch of Douglas/pouch of Douglas adhesions (AUC = 0.82, P < 0.000), ovarian endometriomas/ovarian adhesions (AUC = 0.79, P < 0.000), uterosacral ligaments (AUC = 0.75, P < 0.000) and rectovaginal septum (AUC = 0.69, P < 0.05). CONCLUSION: Specialist TVUS is informative in examining the presence of DIE particularly in posterior compartments which may increase surgical complexity. Community TVUS is significantly less beneficial; however, it is more accessible to the general public. This adds to the argument that increasing access to DIE-TVUS appears favourable.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Laparoscopy Ultrasonography Adult Endometriosis Endometriosis Female Humans Laparoscopy Middle Aged Predictive Value of Tests Retrospective Studies Sensitivity and Specificity Ultrasonography

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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