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This retrospective study evaluated the diagnostic accuracy of transvaginal ultrasound, sonovaginography, and magnetic resonance imaging for detecting ovarian and deep endometriosis in 301 patients who underwent surgical confirmation between 2010 and 2023. Transvaginal ultrasound demonstrated high sensitivity and specificity for ovarian endometriosis, while both sonovaginography and magnetic resonance imaging showed comparable performance for identifying deep infiltrating lesions. The authors note that combining transvaginal ultrasound with sonovaginography provides significant value for diagnosing deep disease, establishing these imaging modalities as reliable tools for pre-surgical assessment. This paper is centrally about endometriosis — specifically focusing on the comparative diagnostic utility of non-invasive imaging techniques for ovarian and deep infiltrating forms of the condition.
Abstract
Objective: To provide estimates of the diagnostic accuracy of transvaginal ultrasound, sonovaginography and magnetic resonance imaging for the diagnosis of ovarian endometriosis and deep endometriosis. Methods: This was an observational, retrospective study carried out in a tertiary center. Consecutive patients who underwent surgical procedures between 2010 and 2023 for diagnosis and treatment of endometriosis were included. The index tests were transvaginal ultrasound, sonovaginography and magnetic resonance imaging. Accuracy of these tests to identify lesions of endometriosis was assessed for different sites, relative to surgical findings. Data was obtained from imaging and surgical reports. Sensitivity, specificity, positive and negative predictive values were calculated for each diagnostic method. Results: Out of 301 patients who underwent surgery, 195 (64.8%) were evaluated with transvaginal ultrasound, 99 (32.9%) had a sonovaginography performed and 167 (55.5%) were evaluated with magnetic resonance imaging. All but 3 (0.01%) patients had endometriosis confirmed through surgical visualization. The sensitivity and specificity for ovarian endometriosis were 95.2% and 83.1% for transvaginal ultrasound and 91.0% and 80.5% for magnetic resonance imaging, respectively. Regarding deep endometriosis, the sensitivity and specificity were 84.1% and 54.5% for sonovaginography and 90.3% and 60.0% for magnetic resonance imaging, respectively. Conclusion: Transvaginal ultrasound was highly accurate for the diagnosis of endometriomas and, when used alongside sonovaginography it had important value in the diagnosis of deep endometriosis as well. Both sonovaginography and magnetic resonance imaging showed similar performance in diagnosing deep endometriosis and stand as reliable diagnostic tools.
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https://hdl.handle.net/10216/158949
| Author(s): | Eva Maria de Jesus Paiva |
| Title: | Endometriosis diagnosis: a retrospective study on the use of transvaginal ultrasound, sonovaginography and magnetic resonance imaging |
| Issue Date: | 2024-05-15 |
| Abstract: | Objective: To provide estimates of the diagnostic accuracy of transvaginal ultrasound, sonovaginography and magnetic resonance imaging for the diagnosis of ovarian endometriosis and deep endometriosis. Methods: This was an observational, retrospective study carried out in a tertiary center. Consecutive patients who underwent surgical procedures between 2010 and 2023 for diagnosis and treatment of endometriosis were included. The index tests were transvaginal ultrasound, sonovaginography and magnetic resonance imaging. Accuracy of these tests to identify lesions of endometriosis was assessed for different sites, relative to surgical findings. Data was obtained from imaging and surgical reports. Sensitivity, specificity, positive and negative predictive values were calculated for each diagnostic method. Results: Out of 301 patients who underwent surgery, 195 (64.8%) were evaluated with transvaginal ultrasound, 99 (32.9%) had a sonovaginography performed and 167 (55.5%) were evaluated with magnetic resonance imaging. All but 3 (0.01%) patients had endometriosis confirmed through surgical visualization. The sensitivity and specificity for ovarian endometriosis were 95.2% and 83.1% for transvaginal ultrasound and 91.0% and 80.5% for magnetic resonance imaging, respectively. Regarding deep endometriosis, the sensitivity and specificity were 84.1% and 54.5% for sonovaginography and 90.3% and 60.0% for magnetic resonance imaging, respectively. Conclusion: Transvaginal ultrasound was highly accurate for the diagnosis of endometriomas and, when used alongside sonovaginography it had important value in the diagnosis of deep endometriosis as well. Both sonovaginography and magnetic resonance imaging showed similar performance in diagnosing deep endometriosis and stand as reliable diagnostic tools. |
| Description: | Objetivo: Obter estimativas da capacidade diagnóstica da ecografia transvaginal, sonovaginografia e ressonância magnética para o diagnóstico de endometriose ovárica e profunda. Métodos: Este foi um estudo observacional retrospetivo que decorreu num centro terciário. Foram incluídos pacientes sujeitos a procedimentos cirúrgicos para o diagnóstico e tratamento de endometriose entre 2010 e 2023. A capacidade da ecografia transvaginal, sonovaginografia e ressonância magnética para a identificação de lesões de endometriose foi avaliada para diferentes localizações, tendo por referência os achados cirúrgicos. Os dados foram obtidos a partir dos relatos imagiológicos e cirúrgicos. Para cada método diagnóstico foram calculadas as seguintes medidas: sensibilidade, especificidade, valores preditivos positivos e negativos. Resultados: De 301 pacientes submetidos a cirurgia, 195 (64.8%) realizaram ecografia transvaginal, 99 (32.9%) efetuaram sonovaginografia e 167 (55.5%) foram avaliados com ressonância magnética. O diagnóstico de endometriose foi confirmado, através de visualização direta, em todos os pacientes exceto 3 (0.01%). A sensibilidade e especificidade da ecografia transvaginal para o diagnóstico de endometriose ovárica foram 95.2% e 83.1% e da ressonância magnética foram 91.0% e 80.5%, respetivamente. Relativamente ao diagnóstico de endometriose profunda, obtivemos sensibilidade e especificidade de 84.1% e 54.5% para a sonovaginografia e de 90.3% e 60.0% para a ressonância magnética, respetivamente. Conclusão: A ecografia transvaginal mostou um desempenho excelente no diagnóstico de endometriomas e, quando usada em conjunto com a sonovaginografia, revelou grande valor para o diagnóstico de endometriose profunda. Tanto a sonovaginografia como a ressonância magnética obtiveram resultados semelhantes para o diagnóstico de endometriose profunda e afirmam-se como métodos de imagem confiáveis. |
| Subject: | Medicina clínica Clinical medicine |
| Scientific areas: | Ciências médicas e da saúde::Medicina clínica Medical and Health sciences::Clinical medicine |
| DOI: | 10.34626/j5vm-d675 |
| TID identifier: | 203751647 |
| URI: | https://hdl.handle.net/10216/158949 |
| Document Type: | Dissertação |
| Rights: | restrictedAccess |
| License: | https://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Appears in Collections: | FMUP - Dissertação |
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| File | Description | Size | Format | |
|---|---|---|---|---|
| 674528.pdf Restricted Access | Endometriosis diagnosis: a retrospective study on the use of transvaginal ultrasound, sonovaginography and magnetic resonance imaging | 2.08 MB | Adobe PDF | View/Open |
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