Diagnosis of pelvic endometriosis with use of macroscopic versus histologic findings

Marchino, Gian Luigi; Gennarelli, Gianluca; Enria, Raffaella; Bongioanni, Francesca; Lipari, Giovanni; Massobrio, M

doi:10.1016/j.fertnstert.2004.09.042

Cited by 81 publications

(43 citation statements)

References 14 publications

(14 reference statements)

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“…In patients with peritoneal endometriosis, laparoscopic resection extends the pain-free interval; however, microlesions cannot be distinguished from normal tissues and not all endometriosis lesions are macroscopically identified, resulting in incomplete relief of pain after surgery. Macroscopic identification of endometriosis lesions is currently poor, with histological examination having a positive predictive value of 65% for suspect lesions in laparoscopy (34). NBI may facilitate macroscopic identification of peritoneal endometriosis through imaging of microvascular structures, since inflammatory reactions, angiogenesis and changes in the microvascular structure occur in the early stage of lesion formation.…”

Section: Use Of Nbi In Gynecologymentioning

confidence: 99%

Narrow band imaging in gynecology: A new diagnostic approach with improved visual identification (Review)

Kisu

Banno

Tsuji³

et al. 2011

Int J Oncol

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Abstract. Narrow band imaging (NBI) is a new endoscopic technique in which images of mucosal microstructures and capillary structures are enhanced by shifting the light spectrum to a narrow band. Image-enhanced gastrointestinal endoscopy using NBI has improved the qualitative diagnosis of the grade and depth of invasion of an atypical lesion. NBI is currently not commonly used in gynecological endoscopy, but has recently been applied in laparoscopy and hysteroscopy. The utility of NBI for diagnosis of endometrial lesions and endometriosis has also been shown. In gynecological endoscopy, NBI provides enhanced images of mucosal microstructures and capillary structures and improves visual identification of lesions. Therefore, image-enhanced observation using NBI is likely to be useful for improved detection of lesions in endoscopic diagnosis. However, this technique remains experimental so far, and no study has demonstrated improved clinical outcome using this technique. In this review, we discuss the utility and potential applications of NBI in clinical practice in gynecology.

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Section: Use Of Nbi In Gynecologymentioning

confidence: 99%

Narrow band imaging in gynecology: A new diagnostic approach with improved visual identification (Review)

Kisu

Banno

Tsuji³

et al. 2011

Int J Oncol

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“…Space does not permit a comprehensive review of this condition but a brief summary will introduce its relationship to laparoscopy and myofascial dysfunction [33][34][35] . Endometriosis is a developmental abnormality in which there is endometrium-like tissue in ectopic locations of the pelvis and rarely in other areas of the body and requires pathological review for the confirmations of diagnosis 36 . It has been reported that the disease can occur in any area of the body with the exception of the spleen.…”

Section: Laparoscopy For Endometriosismentioning

confidence: 99%

Myofascial Dysfunction and Its Relationship to Laparoscopy

Jarrell¹

2011

Advanced Gynecologic Endoscopy

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“…Unfortunately, visual assessment of lesions has poor intra-physician agreement and high rates of misdiagnosis (5) and correlates poorly with actual histologic findings (4,(6)(7)(8)(9)(10)(11)(12)(13)(14). Presurgical screening tests to increase the probability of a woman having endometriosis at surgery are one way to improve the likelihood of accurate diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…The heterogeneity of lesion characteristics suggests that visual inspection may not be sufficient to identify endometriosis (9), especially when subtle lesions are present. Thus development of a model synthesizing multiple factors might improve the accuracy of diagnosis or at least guide the surgeon regarding which lesions are most likely to be positive on biopsy.…”

Section: Introductionmentioning

confidence: 99%

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A logistic model for the prediction of endometriosis

Stegmann

Funk

Sinaii

et al. 2009

Fertility and Sterility

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Objective-To develop a model using individual and lesion characteristics to help surgeons choose lesions with a high probability of containing histologically-confirmed endometriosis.Design-Secondary analysis of prospectively collected information. Setting: Government research hospital.Patients-Healthy women aged 18-45 with chronic pelvic pain and possible endometriosis, enrolled in a clinical trial.Intervention-All participants underwent laparoscopy, and information was collected on all visible lesions. Lesion data were randomly allocated to a training and test dataset. Main Outcome Measures(s)-Predictive logistic regression with the outcome of interest being histologic diagnosis of endometriosis.Results-After validation, the model was applied to the complete dataset with a sensitivity of 88.4% and specificity of 24.6%. The positive predictive value was 69.2% and the negative predictive value was 53.3%, equating to correct classification of a lesion of 66.5%. Mixed color, larger width and location in the ovarian fossa, colon, or appendix were most strongly associated with the presence of endometriosis.Conclusions-This model identified characteristics which indicated a high and low probability of biopsy-proven endometriosis. It is useful as a guide in choosing appropriate lesions for biopsy, but is not sufficiently robust to use alone.

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Diagnosis of pelvic endometriosis with use of macroscopic versus histologic findings

Cited by 81 publications

References 14 publications

Narrow band imaging in gynecology: A new diagnostic approach with improved visual identification (Review)

Narrow band imaging in gynecology: A new diagnostic approach with improved visual identification (Review)

Myofascial Dysfunction and Its Relationship to Laparoscopy

A logistic model for the prediction of endometriosis

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