Diagnostic accuracy of transvaginal sonography for deep pelvic endometriosis.
OBJECTIVE
To determine the accuracy of transvaginal sonography (TVS) for the diagnosis of deep pelvic endometriosis.


METHODS
In a prospective study, 142 women with clinical signs of endometriosis underwent TVS followed by surgical and histopathological investigations. The presence and extent of endometriosis involving the uterosacral ligaments, vagina, rectovaginal septum, intestines, bladder and ovaries shown by TVS were compared with surgical and histological findings. The sensitivity, specificity, predictive values and accuracy of TVS for predicting deep pelvic endometriosis were assessed.


RESULTS
Ovarian and deep pelvic endometriosis were found by surgery and histology in respectively 83 (58.5%) and 79 (55.6%) of the 142 patients. The sensitivity, specificity, and positive and negative predictive values of TVS for the diagnosis of deep pelvic endometriosis were 78.5%, 95.2%, 95.4% and 77.9%, respectively. The sensitivity and specificity of TVS for endometriotic involvement of the uterosacral ligaments, vagina, rectovaginal septum and intestines were 70.6% and 95.9%, 29.4% and 100%, 28.6% and 99.3%, and 87.2% and 96.8%, respectively. The sensitivity and specificity of TVS for bladder involvement were 71.4% and 100%, respectively.


CONCLUSIONS
TVS accurately diagnoses intestinal and bladder endometriosis, but is less accurate for uterosacral, vaginal and rectovaginal septum involvement.
Department of Radiology, Hôpital Tenon, Paris, France. marc.bazot@tnn.ap-hop-paris.fr
M
M
Bazot
I
I
Thomassin
R
R
Hourani
A
A
Cortez
E
E
Darai
D000328:Adult; D000368:Aged; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005831:Genital Diseases, Female / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging / Q000473:pathology