Imagerie préopératoire dans l’endométriose profonde : échographie pelvienne, écho-endoscopie rectale et IRM

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Pelvic ultrasound, rectal echo-endoscopy, and MRI are imaging techniques used to assess deep endometriosis and guide surgical planning.

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Abstract

ObjectivesCompare the accuracy of transvaginal ultrasonography (TVUS), rectal endoscopic sonography (RES), and magnetic resonance imaging (MRI) before deeply infiltrating endometriosis surgery.Patients and methodsA retrospective study with 25 deeply endometriosis patients underwent the three imaging examinations before surgery. Calculation of sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the different locations: ovaries, uterosacral ligaments and torus, rectovaginal septum, rectosigmoid junction, bladder.ResultsOvarian and deep pelvic endometriosis was found in surgery and confirmed by histology in all patients. Sensitivity and specificity are respectively: for ovaries: 88.2% and 71% of TVUS; 80% and 81.2% of RES; 87.5% and 71% of MRI. For uterosacral ligaments: 63% and 82,6% of TVUS; 37% and 100% of RES; 69% and 82.6% of MRI. For torus: 57.1% and 100% of TVUS; 76.2% and 100% of RES; 76.2% and 100% of MRI. For rectovaginal septum: 63.2% and 100% for TVUS; 89.5% and 66.7% of EER; 47.4% and 100% of MRI. For rectosigmoid junction: 73.7% and 66.7% of TVUS; 94.7% and 66.7% of RES; 89.5% and 50% of MRI. For bladder: 16.7% and 100% of TVUS; 16.7% and 100% of RES; 33.3% and 89.5% of MRI.Discussion and conclusionWe found that TVUS is the more performant for endometriomas, it is MRI for torus, uterosacral ligaments and little bladder lesions, RES for rectovaginal septum and rectosigmoid junction. So in the clinical practice, the three imaging examinations are complementary for the preoperative assessment of deeply endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Adult Endometriosis Endoscopy Female Humans Magnetic Resonance Imaging Middle Aged Ovary Ovary Pelvis Pelvis Preoperative Period Rectum Rectum Retrospective Studies Sensitivity and Specificity Ultrasonography Ultrasonography

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