Diagnostic accuracy of transvaginal ultrasound for non‐invasive diagnosis of bowel endometriosis: systematic review and meta‐analysis

G Hudelist, Gernot Hudelist, Jane A. English, J English, A E Thomas, A. Thomas, Andrea Tinelli, A Tinelli, CF Singer, C F Singer, J Keckstein
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2010 · vol. 37(3) , pp. 257–263 · doi:10.1002/uog.8858 · PMID:20954166 · W1983344428
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Transvaginal ultrasound is an accurate method for non-invasively detecting deep infiltrating endometriosis of the rectosigmoid before surgery.

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Abstract

OBJECTIVE: To critically analyze the diagnostic value of transvaginal sonography (TVS) for non-invasive, presurgical detection of bowel endometriosis. METHODS: MEDLINE (1966-2010) and EMBASE (1980-2010) databases were searched for relevant studies investigating the diagnostic accuracy of TVS for diagnosing deep infiltrating endometriosis involving the bowel. Diagnosis was established by laparoscopy and/or histopathological analysis. Likelihood ratios (LRs) were recalculated in addition to traditional measures of effectiveness. RESULTS: Out of 188 papers, a total of 10 studies fulfilled predefined inclusion criteria involving 1106 patients with suspected endometriosis. The prevalence of bowel endometriosis varied from 24 to 73.3%. LR+ ranged from 4.8 to 48.56 and LR- ranged from 0.02 to 0.36, with wide confidence intervals. Pooled estimates of sensitivities and specificities were 91 and 98%; LR+ and LR- were 30.36 and 0.09; and positive and negative predictive values were 98 and 95%, respectively. Three of the studies used bowel preparations to enhance the visibility of the rectal wall; one study directly compared the use of water contrast vs. no prior bowel enema, for which the LR- was 0.04 and 0.47, respectively. CONCLUSIONS: TVS with or without the use of prior bowel preparation is an accurate test for non-invasive, presurgical detection of deep infiltrating endometriosis of the rectosigmoid.

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Condition tags

mesh:D004715endometriosisdie_deep_infiltratingbowel_endometriosis

MeSH descriptors

Endometriosis Endosonography Inflammatory Bowel Diseases Endometriosis Endometriosis Endosonography Endosonography Female Humans Inflammatory Bowel Diseases Inflammatory Bowel Diseases Predictive Value of Tests Preoperative Care Sensitivity and Specificity Vagina

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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Cited by (50)

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