Diagnostic accuracy of physical examination, transvaginal sonography, rectal endoscopic sonography, and magnetic resonance imaging to diagnose deep infiltrating endometriosis.
OBJECTIVE
To compare the value of physical examination, transvaginal sonography (TVS), rectal endoscopic sonography (RES), and magnetic resonance imaging (MRI) for the assessment of different locations of deep infiltrating endometriosis (DIE).


METHODS
Retrospective longitudinal study.


METHODS
Tertiary university gynecology unit.


METHODS
Ninety-two consecutive patients with clinical evidence of pelvic endometriosis.


METHODS
Physical examination, TVS, RES, and MRI, performed preoperatively.


METHODS
Descriptive statistics, calculation of likelihood ratios (LR(+) and LR(-)) of physical examination, TVS, RES, and MRI for DIE in specific locations confirmed by surgery/histology.


RESULTS
The sensitivity and LR(+) and LR(-) values of physical examination, TVS, RES, and MRI were, respectively, 73.5%, 3.3, and 0.34, 78.3%, 2.34, and 0.32, 48.2%, 0.86, and 1.16, and 84.4%, 7.59, and 0.18 for uterosacral ligament endometriosis; 50%, 3.88, and 0.57, 46.7%, 9.64, and 0.56, 6.7%, -, and 0.93, and 80%, 5.51, and 0.23 for vaginal endometriosis; and 46%, 1.67, and 0.75, 93.6%, -, and 0.06, 88.9%, 12.89, and 0.12, and 87.3%, 12.66, and 0.14 for intestinal endometriosis.


CONCLUSIONS
The MRI performs similarly to TVS and RES for the diagnosis of intestinal endometriosis but has higher sensitivity and likelihood ratios for uterosacral ligament and vaginal endometriosis.
Bazot
Marc
M
Services de Radiologie, Hôpital Tenon, Paris, France. marc.bazot@tnn.aphp.fr
Lafont
Clarisse
C
Rouzier
Roman
R
Roseau
Gilles
G
Thomassin-Naggara
Isabelle
I
Daraï
Emile
E
D000328:Adult; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology; D019160:Endosonography / Q000592:standards*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008875:Middle Aged; D010808:Physical Examination / Q000592:standards*; D011300:Preoperative Care; D012007:Rectum; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014621:Vagina; D055815:Young Adult