Diagnosis of Deep Infiltrating Endometriosis Using Transvaginal Ultrasonography.

Shaoli Yin,Yujuan Zhang,Fanhua Xu,Qi Lin,Jinfeng Xu

doi:10.3389/fmed.2020.567929

Abstract

Objective: To evaluate the performance of transvaginal ultrasonography (TVS) in diagnosis of deep infiltrating endometriosis (DIE).Methods: We retrospectively analyzed 198 patients with pathological diagnosis of DIE in our hospital from January 2017 to December 2019 and assessed the performances of pre-operative TVS diagnosis of DIE with regarding to sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV), using the pathological diagnosis as the ground truth. We also characterized the ultrasonographic features of the DIE lesions.Results: Among all the 198 cases, 170 cases were uterosacral ligament (USL) involvement, SE: 96.47% and SP: 85.71%; 79 cases were intestinal involvement, SE: 94.94% and SP: 94.96%; 57 cases were vaginal rectal septum (VRS) involvement, SE: 73.68% and SP: 94.33%; 20 cases were vaginal involvement, SE: 50% and SP: 97.21%; three cases were bladder involvement, SE: 66.7% and SP: 100%; nine cases were ureter involvement, SE: 55.56% and SP: 100%; and 10 cases were broad ligament involvement, SE: 10% and SP: 100%.Conclusion: TVS showed high accuracy in diagnosing DIE.

Highlights

Deep infiltrating endometriosis (DIE) is defined as subperitoneal invasion by endometriotic lesions that exceeds 5 mm in depth
DIE is strongly associated with high levels of pelvic pain, infertility, dysuria, dysmenorrhea, dyspareunia, and gastrointestinal distress, which may seriously affect the quality of life
The purpose of this study was to explore the performance of transvaginal ultrasonography (TVS) in DIE diagnosis

Summary

Introduction

Deep infiltrating endometriosis (DIE) is defined as subperitoneal invasion by endometriotic lesions that exceeds 5 mm in depth. DIE accounts for ∼4–37% of all patients with endometriosis [1]. Because of insufficient understanding of the disease and lack of simple diagnostic tests, a timely diagnosis of DIE is often not available. It has been reported [2,3,4,5] that the average delay of DIE diagnosis (the time from the onset of the first symptom to the clinical diagnosis of endometriosis) was 10 years in Germany, 7 years in Brazil, 11.7 years in the US, and 8 years in the UK. The purpose of this study was to explore the performance of transvaginal ultrasonography (TVS) in DIE diagnosis

Methods

Results

Conclusion