Transvaginal sonography for preoperative assessment of deep endometriosis

Fratelli, N.; Scioscia, Marco; Bassi, Emma; Musola, Mariella; Minelli, Luca; Trivella, Giamberto

doi:10.1002/jcu.22018

Cited by 45 publications

(52 citation statements)

References 29 publications

(35 reference statements)

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“…The rectum, sigmoid, and rectovaginal septum are often considered together, and the Douglas obliteration was described as an indirect sign of DIE (26). Other studies (17,20) reported a lower accuracy compared with our results, probably due to a retrospective analysis of the TVS findings (17) or to the small number of patients (20).…”

Section: Discussioncontrasting

confidence: 75%

“…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%

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Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

Exacoustòs

Malzoni²,

Giovanni³

et al. 2014

Fertility and Sterility

134

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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Section: Discussioncontrasting

confidence: 75%

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

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“…The high accuracy in detecting and describing DIE lesions by transvaginal sonography is similar or better than those obtained by recent studies on magnetic resonance imaging [56,99,100]. For these reasons, it seems that transvaginal sonography is the best diagnostic tool in mapping DIE [36, [48][49][50]57,58].…”

Section: Resultsmentioning

confidence: 58%

“…Although reported sensitivity and specificity of transvaginal sonography in the prediction of DIE is high [47][48][49][50][51][52][53][54][55][56][57][58], evaluation of DIE by transvaginal sonography is difficult and requires expertise. Therefore, some easily detectable utrasonographic signs have recently been proposed to predict the risk of the presence of DIE.…”

Section: Deep Infiltrating Endometriosis Of the Posterior-lateral Commentioning

confidence: 99%

Imaging for the evaluation of endometriosis and adenomyosis

Exacoustòs

Manganaro

Zupi

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

207

143

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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

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“…In the first round of literature search, out of 317 manuscripts, only 17 articles were included according to the inclusion and exclusion criteria (4,9,16,19,21,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36). The following rounds of literature screen to detect manuscripts regarding modified techniques of TVS identified 12 eligible manuscripts, of which three were already identified in the first literature search (4,19,21) and nine were new manuscripts (13,20,22,23,(37)(38)(39)(40)(41).…”

Section: Resultsmentioning

confidence: 99%

Ultrasound techniques in the diagnosis of deep pelvic endometriosis: algorithm based on a systematic review and meta-analysis

Noventa

Saccardi

Litta

et al. 2015

Fertility and Sterility

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The summary of data regarding diagnostic specificity and sensitivity of TVS in women undergoing surgery for deep endometriosis may allow us to conclude that TVS should remain the first-line method in the evaluation of patients with suspicion of DPE. When TVS is insufficient, second-line "modified-techniques" should be considered. Choosing the most effective technique is a challenge and should be based on patient history and clinical signs/symptoms.

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Transvaginal sonography for preoperative assessment of deep endometriosis

Abstract: TVS appears to be useful for the detection of endometriosis located in the bladder and involving the sigmoid colon, the rectovaginal septum, and the rectum.

Cited by 45 publications

References 29 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

Ultrasound techniques in the diagnosis of deep pelvic endometriosis: algorithm based on a systematic review and meta-analysis

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