Diagnostic Accuracy of Transvaginal Ultrasound in Women with Endometriosis at Deeply Infiltrating, Ovarian, and Superficial Peritoneal Sites

Endometriosis is a chronic inflammatory disease marked by pelvic pain and infertility. It is caused by ectopic implantation of endometrial tissue and affects ten percent of women of child-bearing age worldwide. It is known to negatively impact many aspects of a patient's life, including income and mental health. The average time from symptom appearance to diagnosis is eight to twelve years. This delay is due, in part, to the necessity of a surgical biopsy for diagnosis. This narrative review evaluated literature comparing the accuracy of transvaginal ultrasound (TVUS) against a surgical biopsy for diagnosing endometriosis. The results show consistently high specificity values for TVUS at ovarian and deeply infiltrating implantation sites, with low to moderate sensitivity values. The findings of this review indicate a positive TVUS may be reliable enough to diagnose endometriosis at ovarian and deeply infiltrating sites. However, a negative TVUS cannot rule out endometriosis and should prompt further testing. The results were generally limited by a lack of available research. More research is needed before a conclusion may be drawn about superficial implantation sites.