Volume 20, Issue 5 (May 2022)
IJRM 2022, 20(5): 365-376 |
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1- Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
2- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
3- Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. , azar.nabati1399@gmail.com
2- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
3- Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. , azar.nabati1399@gmail.com
Abstract: (1324 Views)
Background: Early diagnosis and appropriate treatment of endometriosis are vital and may prevent subsequent complications.
Objective: To investigate the diagnostic accuracy of transvaginal ultrasound sonography (TVUS) and transrectal ultrasound sonography for detecting endometriosis considering the age and body mass index (BMI).
Materials and Methods: This was a retrospective cohort study of 119 women scheduled for surgery in a tertiary health care center for clinically suspected endometriosis. Married and virgin women underwent TVUS and transrectal ultrasound sonography, respectively, before laparoscopic excision of endometriotic lesions.
Results: The accuracy of TVUS in the diagnosis of right endometrioma in women with a normal BMI was superior to that in women with a BMI ≥ 30 (95.6% vs. 75.3%; p < 0.001). For the detection of left endometrioma in women with a normal BMI, TVUS demonstrated a sensitivity of 96.9% and a negative predictive value of 92.9%, which was significantly superior to TVUS in women with obesity (sensitivity: 77.4%, negative predictive value: 58.6%). The accuracy of TVUS in the diagnosis of left endometrioma in women under 35 yr was superior to that in women older than 35 yr (93.2% vs. 77.9%; p = 0.04). Similarly, the accuracy of TVUS in the diagnosis of right endometrioma in women under 35 yr was superior to TVUS in women older than 35 yr (86.5% vs. 73.3%; p = 0.04).
Conclusion: Ultrasound can be a useful technique for detecting endometriosis when used adjunctively with the patient’s history and physical findings, especially age and BMI.
Objective: To investigate the diagnostic accuracy of transvaginal ultrasound sonography (TVUS) and transrectal ultrasound sonography for detecting endometriosis considering the age and body mass index (BMI).
Materials and Methods: This was a retrospective cohort study of 119 women scheduled for surgery in a tertiary health care center for clinically suspected endometriosis. Married and virgin women underwent TVUS and transrectal ultrasound sonography, respectively, before laparoscopic excision of endometriotic lesions.
Results: The accuracy of TVUS in the diagnosis of right endometrioma in women with a normal BMI was superior to that in women with a BMI ≥ 30 (95.6% vs. 75.3%; p < 0.001). For the detection of left endometrioma in women with a normal BMI, TVUS demonstrated a sensitivity of 96.9% and a negative predictive value of 92.9%, which was significantly superior to TVUS in women with obesity (sensitivity: 77.4%, negative predictive value: 58.6%). The accuracy of TVUS in the diagnosis of left endometrioma in women under 35 yr was superior to that in women older than 35 yr (93.2% vs. 77.9%; p = 0.04). Similarly, the accuracy of TVUS in the diagnosis of right endometrioma in women under 35 yr was superior to TVUS in women older than 35 yr (86.5% vs. 73.3%; p = 0.04).
Conclusion: Ultrasound can be a useful technique for detecting endometriosis when used adjunctively with the patient’s history and physical findings, especially age and BMI.
Type of Study: Original Article |
Subject:
Reproductive Surgery
References
1. Parasar P, Ozcan P, Terry KL. Endometriosis: Epidemiology, diagnosis and clinical management. Curr Obstet Gynecol Rep 2017; 6: 34-41. [DOI:10.1007/s13669-017-0187-1] [PMID] [PMCID]
2. Parazzini F, Esposito G, Tozzi L, Noli S, Bianchi S. Epidemiology of endometriosis and its comorbidities. Eur J Obstet Gynecol Reprod Biol 2017; 209: 3-7. [DOI:10.1016/j.ejogrb.2016.04.021] [PMID]
3. Koninckx PR, Ussia A, Keckstein J, Wattiez A, Adamyan L. Epidemiology of subtle, typical, cystic, and deep endometriosis: A systematic review. Gynecol Surg 2016; 13: 457-467. [DOI:10.1007/s10397-016-0970-4]
4. Agarwal SK, Chapron C, Giudice LC, Laufer MR, Leyland N, Missmer SA, et al. Clinical diagnosis of endometriosis: A call to action. Am J Obstet Gynecol 2019; 220: 354. [DOI:10.1016/j.ajog.2018.12.039] [PMID]
5. Guerriero S, Ajossa S, Minguez J, Jurado M, Mais V, Melis G, et al. Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in uterosacral ligaments, rectovaginal septum, vagina and bladder: Systematic review and meta‐analysis. Ultrasound Obstet Gynecol 2015; 46: 534-545. [DOI:10.1002/uog.15667] [PMID]
6. Guerriero S, Ajossa S, Orozco R, Perniciano M, Jurado M, Melis G, et al. Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in the rectosigmoid: Systematic review and meta‐analysis. Ultrasound Obstet Gynecol 2016; 47: 281-289. [DOI:10.1002/uog.15662] [PMID]
7. Savelli L. Transvaginal sonography for the assessment of ovarian and pelvic endometriosis: How deep is our understanding? Ultrasound Obstet Gynecol 2009; 33: 497-501. [DOI:10.1002/uog.6392] [PMID]
8. Uppot RN, Sahani DV, Hahn PF, Gervais D, Mueller PR. Impact of obesity on medical imaging and image-guided intervention. AJR Am J Roentgenol 2007; 188: 433-440. [DOI:10.2214/AJR.06.0409] [PMID]
9. Ritchie R, Collin J, Coussios C, Leslie T. Attenuation and de-focusing during high-intensity focused ultrasound therapy through peri-nephric fat. Ultrasound Med Biol 2013; 39: 1785-1793. [DOI:10.1016/j.ultrasmedbio.2013.04.010] [PMID]
10. Nisenblat V, Bossuyt PM, Farquhar C, Johnson N, Hull ML. Imaging modalities for the non‐invasive diagnosis of endometriosis. Cochrane Database Syst Rev 2016; 2: CD009591. [DOI:10.1002/14651858.CD009591.pub2]
11. Ballard K, Seaman H, De Vries CS, Wright J. Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control study-Part 1. BJOG 2008; 115: 1382-1391. [DOI:10.1111/j.1471-0528.2008.01878.x] [PMID]
12. Nnoaham K, Hummelshoj L, Kennedy S, Jenkinson C, Zondervan K, World endometriosis research foundation women's health symptom survey consortium. Developing symptom-based predictive models of endometriosis as a clinical screening tool: Results from a multicenter study. Fertil Steril 2012; 98: 692-701. [DOI:10.1016/j.fertnstert.2012.04.022] [PMID] [PMCID]
13. Lafay Pillet M, Huchon C, Santulli P, Borghese B, Chapron C, Fauconnier A. A clinical score can predict associated deep infiltrating endometriosis before surgery for an endometrioma. Hum Reprod 2014; 29: 1666-1676. [DOI:10.1093/humrep/deu128] [PMID]
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