Bazot M, Thomassin I, Hourani R, Cortez A, Darai E
Department of Radiology, Hôpital Tenon, Paris, France.
Ultrasound Obstet Gynecol. 2004 Aug;24(2):180-5. doi: 10.1002/uog.1108.
To determine the accuracy of transvaginal sonography (TVS) for the diagnosis of deep pelvic endometriosis.
In a prospective study, 142 women with clinical signs of endometriosis underwent TVS followed by surgical and histopathological investigations. The presence and extent of endometriosis involving the uterosacral ligaments, vagina, rectovaginal septum, intestines, bladder and ovaries shown by TVS were compared with surgical and histological findings. The sensitivity, specificity, predictive values and accuracy of TVS for predicting deep pelvic endometriosis were assessed.
Ovarian and deep pelvic endometriosis were found by surgery and histology in respectively 83 (58.5%) and 79 (55.6%) of the 142 patients. The sensitivity, specificity, and positive and negative predictive values of TVS for the diagnosis of deep pelvic endometriosis were 78.5%, 95.2%, 95.4% and 77.9%, respectively. The sensitivity and specificity of TVS for endometriotic involvement of the uterosacral ligaments, vagina, rectovaginal septum and intestines were 70.6% and 95.9%, 29.4% and 100%, 28.6% and 99.3%, and 87.2% and 96.8%, respectively. The sensitivity and specificity of TVS for bladder involvement were 71.4% and 100%, respectively.
TVS accurately diagnoses intestinal and bladder endometriosis, but is less accurate for uterosacral, vaginal and rectovaginal septum involvement.
确定经阴道超声检查（TVS）诊断深部盆腔子宫内膜异位症的准确性。
在一项前瞻性研究中，142名有子宫内膜异位症临床体征的女性接受了TVS检查，随后进行了手术及组织病理学检查。将TVS显示的累及子宫骶韧带、阴道、直肠阴道隔、肠道、膀胱和卵巢的子宫内膜异位症的存在情况及范围与手术和组织学结果进行比较。评估TVS预测深部盆腔子宫内膜异位症的敏感性、特异性、预测值及准确性。
142例患者中，手术及组织学检查分别发现83例（58.5%）卵巢子宫内膜异位症和79例（55.6%）深部盆腔子宫内膜异位症。TVS诊断深部盆腔子宫内膜异位症的敏感性、特异性、阳性预测值和阴性预测值分别为78.5%、95.2%、95.4%和77.9%。TVS对子宫骶韧带、阴道、直肠阴道隔和肠道子宫内膜异位累及的敏感性和特异性分别为70.6%和95.9%、29.4%和100%、28.6%和99.3%、87.2%和96.8%。TVS对膀胱累及的敏感性和特异性分别为71.4%和100%。
TVS能准确诊断肠道和膀胱子宫内膜异位症，但对子宫骶韧带、阴道和直肠阴道隔受累情况的诊断准确性较低。
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