Comparison of transvaginal sonography and double‐contrast barium enema for diagnosing deep infiltrating endometriosis of the posterior compartment

Savelli, L.; Manuzzi, Lisa; Coe, Manuela; Mabrouk, Mohamed; Donato, Nadine Di; Venturoli, Stefano; Seracchioli, Renato

doi:10.1002/uog.9072

Cited by 45 publications

(44 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The accuracy of TVS for detecting posterior and lateral DIE lesions (rectum, sigmoid USL, parametria, ureter) is in agreement with previous studies (6,16,18). The rectum, sigmoid, and rectovaginal septum are often considered together, and the Douglas obliteration was described as an indirect sign of DIE (26).…”

Section: Discussionsupporting

confidence: 89%

“…To detect DIE extension into the pelvis, use of magnetic resonance imaging (MRI) (7)(8)(9)(10)(11)(12) and transvaginal sonography (TVS) (6,(13)(14)(15)(16)(17)(18) have been described. The MRI provides accurate information about lesions located on the upper level of the sigmoid, but for pelvic disease TVS is equally accurate and is considered the first and most widely used diagnostic tool (6,(18)(19)(20).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

Exacoustòs

Malzoni²,

Giovanni³

et al. 2014

Fertility and Sterility

134

143

View full text Add to dashboard Cite

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

show abstract

Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

Exacoustòs

Malzoni²,

Giovanni³

et al. 2014

Fertility and Sterility

134

143

View full text Add to dashboard Cite

show abstract

“…Savelli et al [65] compared transvaginal sonography and DCBE in the diagnosis of bowel DIE in terms of presence or absence of the lesion. They reported a sensitivity for ultrasound of 91% and for DBCE 43%; specificity was 100% and 100%, positive predictive value was 100% and 100%, negative predictive value was 29% and 6% and accuracy was 91% and 45%, respectively.…”

Section: Double-contrast Barium Enemamentioning

confidence: 99%

Imaging for the evaluation of endometriosis and adenomyosis

Exacoustòs

Manganaro

Zupi

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

207

143

View full text Add to dashboard Cite

Endometriosis affects between 5 and 45% of women in reproductive age, is associated with significant morbidity, and constitutes a major public health concern. The correct diagnosis is fundamental in defining the best treatment strategy for endometriosis. Therefore, non-invasive methods are required to obtain accurate diagnoses of the location and extent of endometriotic lesions. Transvaginal sonography and magnetic resonance imaging are used most frequently to identify and characterise lesions in endometriosis. Subjective impression by an experienced sonologist for identifying endometriomas by ultrasound showed a high accuracy. Adhesions can be evaluated by real-time dynamic transvaginal sonography, using the sliding sign technique, to determine whether the uterus and ovaries glide freely over the posterior and anterior organs and tissues. Diagnosis is difficult when ovarian endometriomas are absent and endometriosis causes adhesions and deep infiltrating nodules in the pelvic organs. Magnetic resonance imaging seems to be useful in diagnosing all locations of endometriosis, and its diagnostic accuracy is similar to those obtained using ultrasound. Transvaginal ultrasound has been proposed as first line-line imaging technique because it is well accepted and widely available. The main limitation of ultrasound concerns lesions located above the rectosigmoid junction owing to the limited field-of-view of the transvaginal approach and low accuracy in detecting upper bowel lesions by transabdominal ultrasound. A detailed non-invasive diagnosis of the extension in the pelvis of endometriosis can facilitate the choice of a safe and adequate surgical or medical treatment

show abstract

“…Habár a vizsgálóeljárások közül a CT, virtuális kolonoszkópia [19] és akár az irrigoszkópia [20] is szóba jönne, a fertilis korú, gyakran nullipara nők miatt ezeknek a rutinszerű alkalmazása a sugárterhelés miatt nem javasolt. A bélfalban, illetve a bélfalon kívül elhelyezkedő elválto-zások diagnózisánál a rectalis ultrahangvizsgálat jó szenzitivitással bír, de biztonsággal csak 12-13 cm magassá-gig használható, és a szűkület, illetve megtöretés miatt gyakran még ez a magasság sem érhető el az eszköz számára.…”

Section: Megbeszélésunclassified

Prospektív vizsgálat a sigmoideoscopia diagnosztikai érzékenységének meghatározására vastagbelet infiltráló endometriosisban

et al. 2017

View full text Add to dashboard Cite

Bevezetés és célkitűzés:A colorectalis rendszert érintő endometriosis ellátása multidiszciplináris laparoszkópos teammel javasolt. A bélinfiltráció preoperatív felismerése ehhez elengedhetetlen. Betegek és módszer: 2009-2015 között prospektíven 383, endometriosissal diagnosztizált betegnél történt sigmoideoscopia. Intraluminalis endometriosis, fali infiltrációra jellemző másodlagos jelek (falmerevség, benyomat, megtöretés, vizsgálat alatti fájdalom, suffusio) kerül-tek feldolgozásra. Műtéti indikáció esetén a pozitív esetek multidiszciplináris, a negatív esetek nőgyógyász által vég-zett műtéten estek át. Eredmények: 224 (58,49%) pozitívnak talált beteg közül 108-nál multidiszciplináris műtét történt, a negatívnak bizonyult esetek közül 135 ginekológiai műtéten esett át. 108-ból 103 betegnél a műtét során is igazolódott a bél érintettsége, míg a negatív esetek közül nyolc esetben volt jelentős bélinfiltráció. Teljes sigmoideoscopiás vizsgálat 43,4%-ban volt kivitelezhető. Intraluminalis endometriosis 4,91%-ban, fali merevség 38,39%-ban, benyomat 45,54%-ban, megtöretés 57,14%-ban, fájdalom (narkózis nélkül végzett vizsgálatoknál) 26,06%-ban, suffusio 3,82%-ban fordult elő. A sigmoideoscopia szenzitivitása: 92,8%, specificitása: 96,2% volt. Következtetés: A sigmoideoscopia -tapasztalt endoszkópos esetében -kiemelkedő szenzitivitású eszköz a belet infiltráló endometriosis igazolásában. Orv. Hetil., 2017, 158(7), 264-269.Kulcsszavak: sigmoideoscopia, mélyen infiltráló endometriosis, bélinfiltráció, sebészet Prospective study to determine the diagnostic sensitivity of sigmoidoscopy in bowel endometriosis Introduction and aim: In the treatment of colorectal endometriosis a multidisciplinary laparoscopic resection is suggested, for this reason the correct selection of bowel infiltration is essential before surgery. Patients and method: Between 2009 and 2015, 383 sigmoidoscopies were performed in patients with endometriosis. Where mucosal invasion was absent secondary signs (wall rigidity, impression, kinking, pain during the examination, suffusion) were analysed. In endoscopically confirmed cases multidisciplinary surgery was performed, the remaining patients were operated by a gynecologic team only. Results: Endometriosis was endoscopically confirmed in 224 patients (58.49%), 108 of them underwent multidisciplinary operation, the negative 135 cases received gynaecological surgery. Bowel endometriosis was confirmed in 103 out of 108 cases intraoperatively, while in 8 cases of the sigmoidoscopically negative patients bowel infiltration was diagnosed intraoperatively by the gynaecological team. Complete sigmoidoscopy was performed in 43.47% of the cases. Intraluminal endometriosis was found in 4.91%, secondary signs as rigidity in 38.39%, impression in 45.54%, kinking in 57.14%, pain (in cases of examination without narcosis) in 26.06% and suffusion in 3.82% of the cases was found during sigmoidoscopy. Sigmoidoscopic examination has a 92.8% specificity and 96.2% sensitivity in cases of bowel endometriosis. Conclusion: Sig...

show abstract

Comparison of transvaginal sonography and double‐contrast barium enema for diagnosing deep infiltrating endometriosis of the posterior compartment

Abstract: Objectives To compare the diagnostic accuracy of transvaginal sonography (TVS) and double-contrast barium enema (DCBE) in the preoperative detection of deep infiltrating endometriosis (DIE) of the posterior compartment. Methods

Cited by 45 publications

References 21 publications

Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

Imaging for the evaluation of endometriosis and adenomyosis

Prospektív vizsgálat a sigmoideoscopia diagnosztikai érzékenységének meghatározására vastagbelet infiltráló endometriosisban

Contact Info

Product

Resources

About