title: Diagnostic accuracy of physical examination, transvaginal sonography, rectal endoscopic sonography, and magnetic resonance imaging to diagnose deep infiltrating endometriosis.
abstract: 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.
authors.affiliation: Services de Radiologie, Hôpital Tenon, Paris, France. marc.bazot@tnn.aphp.fr
authors.forename: Marc
authors.initials: M
authors.lastname: Bazot
authors.forename: Clarisse
authors.initials: C
authors.lastname: Lafont
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
authors.forename: Gilles
authors.initials: G
authors.lastname: Roseau
authors.forename: Isabelle
authors.initials: I
authors.lastname: Thomassin-Naggara
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
mesh_terms: 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