OP20.05: Three‐dimensional ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of deep endometriosis

The aim of the present study was to evaluate the diagnostic accuracy of three-dimensional (3D) ultrasonography in comparison with magnetic resonance imaging (MRI). This diagnostic test study included 117 patients scheduled for surgery because of clinical suspicion of deep pelvic endometriosis. Two locations of deep endometriosis were considered: intestinal involvement and other posterior lesions (including vaginal location, rectovaginal septum and uterosacral ligaments). After 3D acquisition, a presumptive diagnosis of the presence and localization of deep endometriosis was performed using virtual navigation. Within 2 months of ultrasonographic scan, all patients were submitted to MRI and these two locations were evaluated. The prevalence of intestinal involvement and other posterior lesions at surgery was 42.90% and 45.70% respectively. The AUCs for endometriosis of intestinal location and for endometriosis of other posterior locations were similar for both techniques. For the intestinal involvement, the specificity, sensitivity, LR + and LR- were 96.70% (92.10%–100.00%), 91.10% (82.80%–99.40%), 27.333, 0.092, respectively, for 3D ultrasound and 91.70% (84.70%–98.70%), 95.60% (89.50%–100.00%), 11,467 and 0,048, respectively, for MRI. For other posterior locations, the specificity, sensitivity, LR + and LR- were 86.00% (76.90%–95.00%), 85.40% (75.40%–95.40%), 6,086 and 0,170, respectively, for 3D ultrasound and 89.60% (80.90%–98.20%), 87.70% (79.20%–96.20%), 7,295 and 0,119, respectively, for MRI. Both techniques showed a similar diagnostic accuracy in the diagnosis of deep endometriosis of the posterior compartment. Study funding/competing interest(s): this study was supported in part by the Regione Autonoma della Sardegna (project code CPR-24750)