Early Pregnancy and Gynaecology Assessment Unit, Department of Obstetrics and Gynaecology, King's College Hospital, London, UK.
Ultrasound Obstet Gynecol. 2013 Feb;41(2):210-5. doi: 10.1002/uog.11216.
To examine the reproducibility of assessment of severity of pelvic endometriosis by transvaginal sonography (TVS).
This was a prospective observational study conducted from August 2006 to July 2009 in two academic departments of obstetrics and gynecology. Women with clinically suspected or proven pelvic endometriosis were invited to join the study. All patients included underwent TVS performed by two observers and a laparoscopic assessment of pelvic endometriosis. The ultrasound observers were blinded to each other's results. The reproducibility of TVS was examined by evaluation of interobserver agreement for the American Society of Reproductive Medicine (ASRM) score by Bland-Altman analysis and the stage and the diagnosis of deeply infiltrating endometriosis (DIE) by calculation of kappa coefficients. Agreement between the findings on TVS for each observer and those on laparoscopy was also evaluated.
Thirty-four patients were recruited to the study, and TVS was performed by two ultrasound observers. Of these patients, one did not undergo laparoscopy and was therefore excluded from the final analysis. No endometriosis was found in 12 (36.4%) patients. One patient (3%) had minimal disease, one (3%) had mild disease, five (15.2%) had moderate disease and 14 (42.4%) had severe disease. Interobserver agreement was very good for disease classification on TVS (Cohen's kappa, 0.931). Agreement between TVS and laparoscopy findings was also very good (Cohen's kappa, 0.955 and 0.966 for the two examiners). For ASRM score on TVS, the interobserver 95% limits of agreement were -16.6 to 12.7, with a mean difference of -1.9 (95% CI, -4.35 to 0.71).
TVS is a reproducible method for assessment of the severity of pelvic endometriosis and shows good agreement with findings on laparoscopy.
探讨经阴道超声（TVS）评估盆腔子宫内膜异位症严重程度的可重复性。
这是一项前瞻性观察性研究，于 2006 年 8 月至 2009 年 7 月在两个妇产科学术部门进行。邀请患有临床疑似或确诊的盆腔子宫内膜异位症的女性参加研究。所有纳入的患者均接受了两位观察者进行的 TVS 检查和腹腔镜评估盆腔子宫内膜异位症。超声观察者彼此不了解对方的结果。通过 Bland-Altman 分析评估美国生殖医学学会（ASRM）评分的观察者间一致性，以及通过计算 Kappa 系数评估深部浸润性子宫内膜异位症（DIE）的分期和诊断来评估 TVS 的可重复性。还评估了每位观察者的 TVS 检查结果与腹腔镜检查结果之间的一致性。
该研究共纳入 34 名患者，由两位超声观察者进行 TVS 检查。其中一名患者因未行腹腔镜检查而被排除在最终分析之外。12 名（36.4%）患者未发现子宫内膜异位症。1 名（3%）患者为轻度疾病，1 名（3%）患者为轻度疾病，5 名（15.2%）患者为中度疾病，14 名（42.4%）患者为重度疾病。TVS 疾病分类的观察者间一致性非常好（Cohen's kappa，0.931）。TVS 与腹腔镜检查结果之间的一致性也非常好（两位检查者的 Cohen's kappa 分别为 0.955 和 0.966）。对于 TVS 的 ASRM 评分，观察者间 95%的一致性界限为-16.6 至 12.7，平均差异为-1.9（95%置信区间，-4.35 至 0.71）。
TVS 是一种评估盆腔子宫内膜异位症严重程度的可重复方法，与腹腔镜检查结果具有良好的一致性。
