Diagnostic value of transvaginal 'tenderness-guided' ultrasonography for the prediction of location of deep endometriosis

Guerriero, S.; Ajossa, Silvia; Gerada, M.; Virgilio, B.; Angioni, Stefano; Melis, Gian Benedetto

doi:10.1093/humrep/den293

Cited by 155 publications

(177 citation statements)

References 27 publications

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“…These results are consistent with Yantiss et al (35) and Koga et al (24), who suggested that advanced DIE involving the recto-sigmoid is characterized by thickening of the muscularis propria, fibrotic adhesions and convergence of the serosa. This explains the sonographic aspect of these nodules, which appear as homogeneous, hypoechoic irregularly shaped areas, described by Guerriero et al (7) as having the ''Indian head dress'' sign, and in MRI appear as hypo/iso-intense T2/T1 nodules with irregular contours (web sign).…”

Section: Mri and Tg-tvus Had A Similar Diagnostic Accuracy And Good Imentioning

confidence: 81%

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MRI and “Tenderness Guided” transvaginal ultrasonography in the diagnosis of recto‐sigmoid endometriosis

Saba

Guerriero

Sulcis

et al. 2011

Magnetic Resonance Imaging

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Purpose: To compare the diagnostic accuracy of MRI and ''tenderness-guided'' transvaginal ultrasonography (tg-TVUS) in the identification of recto-sigmoid endometriosis. Materials and Methods:Institutional Review Board approval for this study was obtained, and written informed consent was given by all patients. This study is compliant with the STARD (Standards for Reporting of Diagnostic Accuracy) method. Fifty-nine patients (mean age, 33 years; range, 21-44 years) with clinical suspicion of deep pelvic endometriosis were prospectively enrolled. They underwent tg-TVUS and MRI before surgery. The characteristics of the MRI signal were analyzed. Mapping of recto-sigmoid endometriosis was performed and tg-TVUS and MR imaging results were compared with surgical and pathological findings. Sensitivity, specificity, and the positive and negative likelihood ratio (LRþ and LRÀ) were calculated. Inter-technique concordance was assessed using the Cohen statistic, and receiver operating characteristic (ROC) curves were obtained. Logistic regression analysis was performed.Results: The prevalence of recto-sigmoid endometriosis was 51%. The specificity, sensitivity, and LRþ and LRÀ were 90%, 73%, 7.089 and 0.297, respectively, for MRI and 86%, 73%, 5.317 and 0.309, respectively, for tg-TVUS. The presence of a high T1 signal spot was an excellent specific finding (100%) but was associated with a low sensitivity (30%). Inter-technique concordance using the Cohen statistic indicated a kappa value of 0.658 (6 0.098 SD). According to the logistic regression equation obtained, the use of both tg-TVUS and MRI allows optimal diagnostic performance.Conclusion: MRI and tg-TVUS show similar results in the identification of recto-sigmoid endometriosis. The Cohen kappa value suggests that these methods may have complementary roles in the identification of recto-sigmoid endometriosis, depending on the site affected.

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Section: Mri and Tg-tvus Had A Similar Diagnostic Accuracy And Good Imentioning

confidence: 81%

“…The ''tenderness-guided'' TVUS (tg-TVUS) technique has shown promising results in the detection of DIE (7). MRI enables precise mapping of the nodules of endometriosis and is accepted as a valid imaging technique for evaluation of DIE before surgery (3,(8)(9)(10).…”

mentioning

confidence: 99%

MRI and “Tenderness Guided” transvaginal ultrasonography in the diagnosis of recto‐sigmoid endometriosis

Saba

Guerriero

Sulcis

et al. 2011

Magnetic Resonance Imaging

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“…Many studies have validated the non-surgical diagnosis of endometriomas and deep endometriosis through TV-US [14][15][16][17]. The ultrasound pattern showed similar modification in all patients: DIE plaques and nodules appeared less fibrotic and more homogeneous, with illdefined contours.…”

Section: Commentmentioning

confidence: 90%

The effect of the hormonal milieu of pregnancy on deep infiltrating endometriosis: serial ultrasound assessment of changes in size and pattern of deep endometriotic lesions

Coccia

Rizzello

Palagiano

et al. 2012

European Journal of Obstetrics & Gynecology and Reproductiv

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“…The presence of ovarian endometriomas and adnexal adhesions were also recorded. The diagnosis of DIE was made if at least one structure in the anterior or posterior compartment showed the presence of abnormal retroperitoneal hypoechoic linear or nodular thickening with irregular contours and no or few vessels detectable at power Doppler, as per previously described and validated ultrasonographic criteria (21,22).…”

Section: Ultrasound Examinationmentioning

confidence: 99%

Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

Exacoustòs

Malzoni²,

Giovanni³

et al. 2014

Fertility and Sterility

136

143

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Objective: To assess the accuracy of transvaginal sonography (TVS) in defining size and location of deep infiltrating endometriosis (DIE) with laparoscopic/histologic confirmation. Design: Prospective observational study. Setting: University hospital. Patient(s): One hundred four women with suspected DIE on the basis of TVS. Intervention(s): Patients with DIE underwent TVS evaluation before laparoscopic surgery. An accurate mapping of the extent of the disease was recorded during TVS and at laparoscopy. This new mapping system was developed to assess the extent of endometriosis by measuring the size and depth of the lesions at the various pelvic locations. Main Outcome Measure(s): Surgical and histologic confirmation of the ultrasonographic data to evaluate the presence and location of DIE and creation of a new mapping methodology for detecting DIE by TVS. Result(s): Depending on the different location of the lesions, the accuracy of TVS ranged from 76%-97%. The lowest sensitivity (59%) and accuracy (76%) were obtained for TVS in the diagnosis of vaginal endometriosis, whereas the greatest accuracy (97%) was shown in detecting bladder lesions and Douglas obliteration. Conclusion(s):This new ultrasound mapping system is accurate for detecting the extent of DIE and may be useful for preoperative planning and intraoperative management of symptomatic patients with DIE. (Fertil Steril Ò

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Diagnostic value of transvaginal 'tenderness-guided' ultrasonography for the prediction of location of deep endometriosis

Cited by 155 publications

References 27 publications

MRI and “Tenderness Guided” transvaginal ultrasonography in the diagnosis of recto‐sigmoid endometriosis

MRI and “Tenderness Guided” transvaginal ultrasonography in the diagnosis of recto‐sigmoid endometriosis

The effect of the hormonal milieu of pregnancy on deep infiltrating endometriosis: serial ultrasound assessment of changes in size and pattern of deep endometriotic lesions

Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

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