Department of Obstetrics and Gynecology, University of Cagliari, Ospedale San Giovanni di Dio, Cagliari, Italy.
Fertil Steril. 2010 Jul;94(2):742-6. doi: 10.1016/j.fertnstert.2009.03.035. Epub 2009 Apr 14.
To estimate the diagnostic value of transvaginal ultrasonography in the detection of pelvic adhesions in women suspected of having endometriomas at ultrasonography.
Prospective observational study.
Academic Department of Obstetrics and Gynecology.
PATIENT(S): One hundred thirteen women who underwent surgery for an endometrioma.
INTERVENTION(S): All patients underwent transvaginal ultrasonography before surgery, and at ultrasonography the presence of fixation of the ovary to the uterus was considered characteristic of the presence of pelvic adhesions.
MAIN OUTCOME MEASURE(S): Sensitivity, specificity, and likelihood ratios were calculated with 95% confidence intervals (CIs).
RESULT(S): The sensitivity and specificity of the fixation to the uterus of at least one ovary were respectively 89% (95% CI 84%-92%) and 90% (95% CI 76%-97%). The likelihood ratio for fixation of at least one ovary to the uterus was 8.92 (95% CI 3.04-26) and for a "normal" ultrasound examination 0.12 (95% CI 0.06-0.23). The pretest probability of pelvic adhesions was 74%, and this probability increased to 96% when fixation of at least one ovary to the uterus was present and fell to 27% when this ultrasonographic finding was absent.
CONCLUSION(S): Transvaginal ultrasonography seems to be able to detect or exclude the presence of adhesions in women with ultrasonographic suspicion of endometrioma.
评估经阴道超声检查在超声怀疑子宫内膜异位症患者中检测盆腔粘连的诊断价值。
前瞻性观察性研究。
妇产科学术部门。
113 名因子宫内膜异位症接受手术的女性。
所有患者均在手术前接受经阴道超声检查，超声检查中卵巢与子宫固定被认为是存在盆腔粘连的特征。
计算灵敏度、特异性和似然比，置信区间为 95%。
至少一侧卵巢固定到子宫的灵敏度和特异性分别为 89%（95%CI 84%-92%）和 90%（95%CI 76%-97%）。至少一侧卵巢固定到子宫的似然比为 8.92（95%CI 3.04-26），而“正常”超声检查的似然比为 0.12（95%CI 0.06-0.23）。盆腔粘连的术前概率为 74%，当至少一侧卵巢固定到子宫时，该概率增加到 96%，当这种超声发现不存在时，该概率下降到 27%。
经阴道超声检查似乎能够检测或排除超声怀疑子宫内膜异位症患者存在粘连的情况。
