Alborzi Saeed, Rasekhi Alireza, Shomali Zahra, Madadi Gooya, Alborzi Mahshid, Kazemi Mahboobeh, Hosseini Nohandani Azam
Laparoscopy Research Center, Department of Obstetrics and Gynecology Department of Radiology Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.
Medicine (Baltimore). 2018 Feb;97(8):e9536. doi: 10.1097/MD.0000000000009536.
To determine the diagnostic accuracy of pelvic magnetic resonance imaging (MRI), transvaginal sonography (TVS), and transrectal sonography (TRS) in diagnosis of deep infiltrating endometriosis (DIE).This diagnostic accuracy study was conducted during a 2-year period including a total number of 317 patients with signs and symptoms of endometriosis. All the patients were evaluated by pelvic MRI, TVS, and TRS in the same center. The criterion standard was considered to be the laparoscopy and histopathologic examination.Of 317 patients being included in the present study, 252 tested positive for DIE. The sensitivity, specificity, positive predictive value, and negative predictive value of TVS was found to be 83.3%, 46.1%, 85.7%, and 41.6%, respectively. These variables were 80.5%, 18.6%, 79.3%, and 19.7% for TRS and 90.4%, 66.1%, 91.2%, and 64.1% for MRI, respectively. MRI had the highest accuracy (85.4%) when compared to TVS (75.7%) and TRS (67.8%). The sensitivity of TRS, TVS, and MRI in uterosacral ligament DIE was 82.8%, 70.9%, and 63.6%, respectively. On the contrary, specificity had a reverse trend, favoring MRI (93.9%, 92.8%, and 89.8% for TVS and TRS, respectively).The results of the present study demonstrated that TVS and TRS have appropriate diagnostic accuracy in diagnosis of DIE comparable to MRI.
为确定盆腔磁共振成像（MRI）、经阴道超声检查（TVS）和经直肠超声检查（TRS）在诊断深部浸润型子宫内膜异位症（DIE）中的诊断准确性。这项诊断准确性研究在两年期间进行，共纳入317例有子宫内膜异位症体征和症状的患者。所有患者均在同一中心接受盆腔MRI、TVS和TRS检查。标准参照为腹腔镜检查和组织病理学检查。在本研究纳入的317例患者中，252例DIE检测呈阳性。结果发现，TVS的敏感性、特异性、阳性预测值和阴性预测值分别为83.3%、46.1%、85.7%和41.6%。TRS的这些变量分别为80.5%、18.6%、79.3%和19.7%，MRI分别为90.4%、66.1%、91.2%和64.1%。与TVS（75.7%）和TRS（67.8%）相比，MRI具有最高的准确性（85.4%）。TRS、TVS和MRI在子宫骶骨韧带DIE中的敏感性分别为82.8%、70.9%和63.6%。相反，特异性呈相反趋势，以MRI为优（TVS和TRS分别为93.9%、92.8%和89.8%）。本研究结果表明，TVS和TRS在诊断DIE方面具有与MRI相当的诊断准确性。
