Bazot Marc, Daraï Emile
Department of Radiology, Tenon hospital, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France; Groupe de Recherche Clinique (GRC): GRC6-UPMC, Centre Expert En Endométriose (C3E), Paris, France.
Groupe de Recherche Clinique (GRC): GRC6-UPMC, Centre Expert En Endométriose (C3E), Paris, France; Department of Obstetrics and Gynecology, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie Paris, Paris, France; Inserm UMRS-938, Assistance Publique des Hôpitaux de Paris, Paris, France.
Fertil Steril. 2017 Dec;108(6):886-894. doi: 10.1016/j.fertnstert.2017.10.026.
The aim of the present review was to evaluate the contribution of clinical examination and imaging techniques, mainly transvaginal sonography and magnetic resonance imaging (MRI) to diagnose deep infiltrating (DE) locations using prisma statement recommendations. Clinical examination has a relative low sensitivity and specificity to diagnose DE. Independently of DE locations, for all transvaginal sonography techniques a pooled sensitivity and specificity of 79% and 94% are observed approaching criteria for a triage test. Whatever the protocol and MRI devices, the pooled sensitivity and specificity for pelvic endometriosis diagnosis were 94% and 77%, respectively. For rectosigmoid endometriosis, pooled sensitivity and specificity of MRI were 92% and 96%, respectively fulfilling criteria of replacement test. In conclusion, advances in imaging techniques offer high sensitivity and specificity to diagnose DE with at least triage value and for rectosigmoid endometriosis replacement value imposing a revision of the concept of laparoscopy as the gold standard.
本综述的目的是利用PRISMA声明建议评估临床检查和成像技术（主要是经阴道超声检查和磁共振成像（MRI））对诊断深部浸润（DE）部位的贡献。临床检查对诊断DE的敏感性和特异性相对较低。无论DE的位置如何，对于所有经阴道超声检查技术，观察到的合并敏感性和特异性分别为79%和94%，接近分诊测试的标准。无论采用何种方案和MRI设备，盆腔子宫内膜异位症诊断的合并敏感性和特异性分别为94%和77%。对于直肠乙状结肠子宫内膜异位症，MRI的合并敏感性和特异性分别为92%和96%，分别符合替代测试的标准。总之，成像技术的进步为诊断DE提供了高敏感性和特异性，至少具有分诊价值，对于直肠乙状结肠子宫内膜异位症具有替代价值，这使得腹腔镜作为金标准的概念需要修订。
