title: Endorectal ultrasound accuracy in the diagnosis of rectal endometriosis infiltration depth.
abstract: OBJECTIVE
  To evaluate the accuracy of endorectal ultrasound examination to ascertain the deepest rectal layer involved in rectal endometriosis.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Department of obstetrics and gynecology at a university hospital in France.
  
  
  METHODS
  Women presenting with rectal endometriosis who had undergone rectal resection during a 22-month period.
  
  
  METHODS
  Endorectal ultrasonography.
  
  
  METHODS
  The predicted rectal infiltration depth by using endorectal examination was compared with histological findings. The level of agreement was evaluated by using the coefficients of concordance kappa and weighted kappa.
  
  
  RESULTS
  Sixteen women were included in the study. Rectal resection was segmental in 14 cases and was limited in 2 cases. The agreement between 2 examinations was considered good in 9 cases (56%). Endorectal ultrasound overestimated the depth of infiltration in 5 cases and underestimated it in 2 cases. The coefficients of concordance kappa (95% confidence interval) and weighted kappa (95% confidence interval) were, respectively, 0.17 (0-0.34) and 0.22 (0.04-0.4), corresponding to poor concordance between the endorectal ultrasonography and histological examination.
  
  
  CONCLUSIONS
  Accuracy in the prediction of rectal-layer involvement in endorectal ultrasonography appears to be limited. This information should not be considered sufficient when selecting the type of rectal-resection procedure.
authors.affiliation: Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France. horace.roman@gmail.com
authors.forename: Horace
authors.initials: H
authors.lastname: Roman
authors.forename: Khaled
authors.initials: K
authors.lastname: Kouteich
authors.forename: Alexis
authors.initials: A
authors.lastname: Gromez
authors.forename: Patrick
authors.initials: P
authors.lastname: Hochain
authors.forename: Benoît
authors.initials: B
authors.lastname: Resch
authors.forename: Loïc
authors.initials: L
authors.lastname: Marpeau
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D012002:Rectal Diseases / Q000000981:diagnostic imaging*; D012007:Rectum / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*