Padmehr Roya, Shadjoo Khadijeh, Mohazzab Arash, Gorgin Atefeh, Karegar Roxana, Jaberipour Parvin, Sehat Zahra, Maleki Narges
Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.
Avicenna Infertility Clinic, Avicenna Research Institute, ACECR, Tehran, Iran.
Int J Reprod Biomed. 2023 Jul 24;21(6):471-480. doi: 10.18502/ijrm.v21i6.13634. eCollection 2023 Jun.
Endometriosis is a challenging gynecological disease and a debilitating condition that profoundly affects the individual's quality of life. Besides pathological confirmation, diagnostic laparoscopy has been internationally accepted as the standard method to identify the accurate mapping of endometriosis. Transvaginal sonography (TVS) is the first non-invasive imaging modality to estimate the severity of endometriosis.
This study aimed to evaluate the accuracy of TVS in affected women compared with surgical findings.
This retrospective cross-sectional study surveyed 170 women with deep infiltrating endometriosis (DIE) referred to the endometriosis part of the Avicenna Infertility Center, Tehran, Iran and they underwent TVS followed by laparoscopy. Recorded data of individuals under study in the medical database system were reviewed. Finally, the agreement rate was calculated for ultrasound reports and intraoperative (IO) findings regarding ovarian endometrium, ovarian adhesion, involvement of cul-de-sac, rectovaginal septum, and bowel and ureter.
170 women with DIE entered the study. The agreement of TVS and IO findings were 86.76% for left ovarian endometriosis and 70.86% for right ovarian endometriosis, 93.90% for left ovarian adhesion, and 88.90% for right ovarian adhesion, 88.90% for a cul-de-sac, and 84.82% for bowel nodules. The findings, based on a laparoscopic assessment of the pelvic floor, were completely compatible with ultrasound reports (100%).
TVS allows a preoperative evaluation in planning the surgical policy associated. TVS is beneficial for dedicated mapping of DIE; thus, an expert radiologist can aid the surgeon in preoperative evaluation and IO management.
子宫内膜异位症是一种具有挑战性的妇科疾病，也是一种使人衰弱的病症，会严重影响个人生活质量。除病理确诊外，诊断性腹腔镜检查已被国际公认为确定子宫内膜异位症准确分布图的标准方法。经阴道超声检查（TVS）是评估子宫内膜异位症严重程度的首个非侵入性成像方式。
本研究旨在将TVS与手术结果相比较，评估其在患病女性中的准确性。
这项回顾性横断面研究调查了170名患有深部浸润性子宫内膜异位症（DIE）的女性，她们被转诊至伊朗德黑兰阿维森纳不孕不育中心的子宫内膜异位症科室，先接受TVS检查，随后接受腹腔镜检查。对医学数据库系统中所研究个体的记录数据进行了审查。最后，计算了超声报告与术中（IO）关于卵巢子宫内膜、卵巢粘连、直肠子宫陷凹受累、直肠阴道隔以及肠道和输尿管的检查结果的符合率。
170名患有DIE的女性进入研究。TVS与IO检查结果的符合率在左侧卵巢子宫内膜异位症中为86.76%，右侧卵巢子宫内膜异位症中为70.86%，左侧卵巢粘连中为93.90%，右侧卵巢粘连中为88.90%，直肠子宫陷凹中为88.90%，肠道结节中为84.82%。基于盆底腹腔镜评估的结果与超声报告完全相符（100%）。
TVS有助于在制定相关手术策略时进行术前评估。TVS对DIE的专门分布图绘制有益；因此，专业放射科医生可协助外科医生进行术前评估和术中处理。
