Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in the rectosigmoid: systematic review and meta‐analysis

S. Guerriero, Ajossa S, S. Ajossa, Rodrigo Orozco, Orozco R, R Orozco, Perniciano M, M Perniciano, Jurado M, M. Jurado, G. B. Melis, Melis GB, Gian Benedetto Melis, J L Alcazar, Alcazar JL, Juan Luis Alcázar
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2015 · vol. 47(3) , pp. 281–289 · doi:10.1002/uog.15662 · PMID:26213903 · W2166156501
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Transvaginal ultrasound shows high sensitivity (91%) and specificity (97%) for diagnosing rectosigmoid deep endometriosis, with no significant difference between enhanced and non-enhanced approaches.

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Abstract

OBJECTIVES: To review the diagnostic accuracy of transvaginal ultrasound (TVS) in the preoperative detection of rectosigmoid endometriosis in patients with clinical suspicion of deep infiltrating endometriosis (DIE), comparing enhanced (E-TVS) and non-enhanced approaches. METHODS: An extensive search was performed in MEDLINE (PubMed) and EMBASE for studies published between January 1989 and December 2014. The eligibility criterion was use of TVS for preoperative detection of rectosigmoid endometriosis in women with clinical suspicion of DIE, using surgical data as the reference standard. Study quality was assessed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. RESULTS: Our extended search identified a total of 801 citations, among which 19 studies (n = 2639) were considered eligible and included in the meta-analysis. Overall pooled sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-) of TVS for detecting DIE in the rectosigmoid were 91% (95%CI, 85-94%), 97% (95%CI, 95-98%), 33.0 (95%CI, 18.6-58.6) and 0.10 (95%CI, 0.06-0.16), respectively. Significant heterogeneity was found for sensitivity (I(2) , 90.8%; Cochran Q, 195.2; P < 0.001) and specificity (I(2) , 76.8%; Cochran Q, 77.7; P < 0.001). We did not find statistical differences between non-enhanced TVS and E-TVS (P = 0.304). CONCLUSION: Overall diagnostic performance of TVS for DIE of the rectosigmoid is good. However, further studies with improved quality in design are needed. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Colon, Sigmoid Endometriosis Rectum Ultrasonography Adult Colon, Sigmoid Colon, Sigmoid Endometriosis Endometriosis Female Humans Prospective Studies Rectum Rectum Reproducibility of Results Sensitivity and Specificity Ultrasonography

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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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