Deep Infiltrating Endometriosis: Comparison Between 2‐Dimensional Ultrasonography (US), 3‐Dimensional US, and Magnetic Resonance Imaging

Guerriero, S.; Alcázar, Juan Luis; Pascual, M.; Ajossa, Silvia; Perniciano, M.; Piras, A.; Mais, Valerio; Piras, Bruno; Schirru, Federica; Benedetto, Melis Gian; Saba, Luca

doi:10.1002/jum.14496

Cited by 38 publications

(49 citation statements)

References 30 publications

(51 reference statements)

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“…Ultrasonographic study with 3D modalities has increasingly been employed for the evaluation of many gynecological diseases, being in recent years also investigated for the diagnosis of deep endometriosis [17][18][19]37]. Two previous studies prospectively compared the performance of 3D-RWC-TVS and MR with colorectal enema in the diagnosis of rectosigmoid endometriosis, finding similar accuracy parameters, nevertheless stating the advantage of an accurate visualization and characterization of the nodules by performing the 3D evaluation [38,39].…”

Section: Discussionmentioning

confidence: 97%

“…3D ultrasound has been employed for the evaluation of many gynecological diseases, including uterine shape abnormalities (e.g., Mullerian duct abnormalities), uterine intracavitary pathology (submucous uterine fibroids or endometrial polyps) [16]. The use of 3D-TVS has also been proposed for the diagnosis of deep endometriosis [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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A Prospective Study Comparing Three-Dimensional Rectal Water Contrast Transvaginal Ultrasonography and Computed Tomographic Colonography in the Diagnosis of Rectosigmoid Endometriosis

et al. 2020

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(1) Objectives: In patients with symptoms suggestive of rectosigmoid endometriosis, imaging techniques are required to confirm the presence and establish the extent of the disease. The objective of the current study was to compare the performance of three-dimensional rectal water contrast transvaginal ultrasonography (3D-RWC-TVS) and computed tomographic colonography (CTC) in predicting the presence and characteristics of rectosigmoid endometriosis. (2) Methods: This prospective study included patients with suspicion of rectosigmoid endometriosis who underwent both 3D-RWC-TVS and CTC and subsequently were surgically treated. The findings of imaging techniques were compared with surgical and histological results. (3) Results: Out of 68 women included in the study, 37 (48.9; 95% C.I. 38.2–59.7%) had rectosigmoid nodules and underwent bowel surgery. There was no significant difference in the accuracy of 3D-RWC-TVS and CTC in diagnosing the presence of rectosigmoid endometriotic nodules (p = 0.118), although CTC was more precise in diagnosing endometriosis located in the sigmoid (p = 0.016). 3D-RWC-TVS and CTC had similar precision in estimating the largest diameter of the main endometriotic nodule (p = 0.099) and, in patients undergoing segmental resection, the degree of the stenosis of the bowel lumen (p = 0.293). CTC was more accurate in estimating the distance between the lower margin of the intestinal nodule and the anal verge (p = 0.030) but was less tolerated than 3D-RWC-TVS (p < 0.001). (4) Conclusion: This was the first study comparing the performance of 3D-RWC-TVS and CTC in the diagnosis of rectosigmoid endometriosis. Both techniques allowed for the evaluation of the profile of the bowel lumen in a pseudoendoscopic fashion and had a similar performance for the diagnosis of rectosigmoid endometriosis, although CTC was more accurate in diagnosing and characterizing sigmoid nodules.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

A Prospective Study Comparing Three-Dimensional Rectal Water Contrast Transvaginal Ultrasonography and Computed Tomographic Colonography in the Diagnosis of Rectosigmoid Endometriosis

et al. 2020

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“…11,15,[20][21][22]25,[34][35][36] Recently, Exacoustos et al 23 published an excellent overview on the ability of US to identify endometriosis lesions, not only showing where and what to see but also highlighting the role of real-time dynamic US to improve the accuracy. Other articles focused on the comparison between US and other imaging techniques, 16,17,37 although very few dealt with a very difficult subject such as the differential diagnosis, focusing on ovarian cysts and adenomyosis only. 19,23,38,39 This article reports several cases of differential diagnoses in an attempt to distinguish endometriosis from diseases that may have similar US features.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Differential Diagnosis in Deep Infiltrating Endometriosis of the Urinary Tract

Scioscia

Zanetti

Raspanti

et al. 2020

J of Ultrasound Medicine

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Endometriosis of the urinary tract is a rare condition that may lead to severe complications. At present, the major challenge appears to be the ultrasound differential diagnosis with diseases that can afflict the ureter and the bladder. Preoperative scan findings were compared with surgical and histologic records. Twenty-three cases were selected as being of interest, as they were referred for suspected endometriosis, whereas second-level ultrasound revealed a different disease in some cases. This case series aims to help in becoming familiar with the possible differential diagnosis of lesions of the urinary tract that resemble endometriosis.

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“…Some new ultrasound techniques were also evaluated for the diagnosis of deep infiltrating endometriosis. Guerriero et al[13] compared the diagnostic accuracy of 2-Dimensions ultrasound (DUS) and 3-DUS in patients with deep infiltrating endometriosis confirmed surgically. They showed no significant difference regarding sensitivity, specificity, NPV and PPV between techniques for the intestinal location.…”

Section: Discussionmentioning

confidence: 99%

Preoperative rectosigmoid endoscopic ultrasonography predicts the need for bowel resection in endometriosis

Desplats

Vitte

Cheyron

et al. 2019

WJG

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BACKGROUNDRectosigmoid endometriosis is an underdiagnosed disease responsible for abdominal pain, transit disorders and rectal bleeding. Two surgical approaches, rectosigmoid bowel resection (segmental or patch) or intramuscular layer dissection (shaving), are available.AIMTo assess whether the lesion features observed via preoperative rectosigmoid endoscopic ultrasonography (RS-EUS) might predict the need for bowel resection.METHODSThis multicentric retrospective study was conducted on patients with rectosigmoid endometriosis who underwent a curative surgical procedure, evaluated by RS-EUS performed by two trained operators, between January 2012 and March 2018. A univariate statistical analysis was performed on nodules’ RS-EUS features (thickness, width, infiltration of the submucosae, presence of a bump into the digestive lumen and presence of multiple rectosigmoid localizations). A multivariate logistic regression was then performed on the significant results.RESULTSOf the 367 patients, 73 patients with rectosigmoid endometriosis were evaluated by RS-EUS and underwent rectosigmoid surgery. After the univariate analysis was completed, thickness, width and infiltration of the submucosae were identified as potential predictive factors for bowel resection. In a multivariate logistic regression model, only thickness appeared to be a significant [odds ratio (OR) = 1.49, 95% confidence interval (CI): 1.04-2.12, P = 0.028] predictive factor for bowel resection. Receiver operating characteristic analysis performed showed that a thickness over 5.20 mm might be used as cut-off with a sensitivity of 76%, a specificity of 81%, and an area under carve = 0.82. The cut-off values for 100% sensitivity and 100% specificity were 0.90 mm and 10.00 mm, respectively. A trend concerning width to predict the need for resection was also observed (OR 1.12, 95%CI: 1.00-1.26, P = 0.054)CONCLUSIONThe presence of a rectosigmoid nodule of endometriosis greater than 5.20 mm thick on RS-EUS might predict the need for bowel resection.

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Deep Infiltrating Endometriosis: Comparison Between 2‐Dimensional Ultrasonography (US), 3‐Dimensional US, and Magnetic Resonance Imaging

Abstract: Our results seem to suggest that there is a statistically significant difference between 2DUS and MRI for the intestinal location of deep infiltrating endometriosis, whereas no differences were found among the techniques for the other locations.

Cited by 38 publications

References 30 publications

A Prospective Study Comparing Three-Dimensional Rectal Water Contrast Transvaginal Ultrasonography and Computed Tomographic Colonography in the Diagnosis of Rectosigmoid Endometriosis

A Prospective Study Comparing Three-Dimensional Rectal Water Contrast Transvaginal Ultrasonography and Computed Tomographic Colonography in the Diagnosis of Rectosigmoid Endometriosis

Ultrasound Differential Diagnosis in Deep Infiltrating Endometriosis of the Urinary Tract

Preoperative rectosigmoid endoscopic ultrasonography predicts the need for bowel resection in endometriosis

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