Bergamini Valentino, Ghezzi Fabio, Scarperi Stefano, Raffaelli Ricciarda, Cromi Antonella, Franchi Massimo
Department of Obstetrics and Gynecology, University of Verona, Italy.
Abdom Imaging. 2010 Dec;35(6):732-6. doi: 10.1007/s00261-010-9610-z.
To evaluate the accuracy of Transrectal Sonography (TRS) and a new technique, Transvaginal Sonography with Water-Contrast in the Rectum (RWC-TVS), in the diagnosis of rectosigmoid endometriosis, and the accuracy of Barium Enema (BE) and RWC-TVS in the detection of intestinal stenosis due to endometriosis. In a prospective study, we compared the findings of TRS and RWC-TVS performed before surgery with the operative and pathologic findings in 61 consecutive patients who underwent laparoscopy or laparotomy for suspected rectosigmoid endometriosis. The accuracy of BE and RWC-TVS in the detection of intestinal stenosis was evaluated comparing the radiologic and ultrasonographic results with the macroscopic findings at surgery and pathology. RWC-TVS diagnosed rectosigmoid endometriosis with the same accuracy of TRS and was equally efficient as BE in the detection of a significant intestinal lumen stenosis. For the diagnosis of rectosigmoid endometriosis the sensitivity, specificity, positive and negative predictive values of TRS and RWC-TVS were 88.2% and 96%, 80%, and 90%, 95.7%, and 98%, and 57.1% and 81.8%, respectively. For the detection of intestinal stenosis the sensitivity, specificity, positive and negative predictive values of BE and RWC-TVS were 93.7% and 87.5%, 94.2% and 91.4%, 88.2% and 82.3%, and 97% and 94.1%, respectively. RWC-TVS is a new, simple technique for a single-step and accurate preoperative assessment of rectosigmoid endometriosis.
为评估经直肠超声检查（TRS）以及一种新技术——直肠水造影经阴道超声检查（RWC-TVS）在诊断直肠乙状结肠子宫内膜异位症方面的准确性，以及钡剂灌肠（BE）和RWC-TVS在检测子宫内膜异位症所致肠道狭窄方面的准确性。在一项前瞻性研究中，我们将61例因疑似直肠乙状结肠子宫内膜异位症而接受腹腔镜检查或剖腹手术的连续患者术前进行的TRS和RWC-TVS检查结果与手术及病理结果进行了比较。通过将放射学和超声检查结果与手术及病理的宏观检查结果进行比较，评估了BE和RWC-TVS在检测肠道狭窄方面的准确性。RWC-TVS诊断直肠乙状结肠子宫内膜异位症的准确性与TRS相同，在检测明显的肠腔狭窄方面与BE同样有效。对于直肠乙状结肠子宫内膜异位症的诊断，TRS和RWC-TVS的敏感性、特异性、阳性和阴性预测值分别为88.2%和96%、80%和90%、95.7%和98%、57.1%和81.8%。对于肠道狭窄的检测，BE和RWC-TVS的敏感性、特异性、阳性和阴性预测值分别为93.7%和87.5%、94.2%和91.4%、88.2%和82.3%、97%和94.1%。RWC-TVS是一种用于直肠乙状结肠子宫内膜异位症术前单步准确评估的新的简单技术。
