Baușic Alexandra Irma Gabriela, Matasariu Daniela Roxana, Manu Andrei, Brătilă Elvira
Department of Obstetrics and Gynecology, Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Biomedicines. 2023 Sep 23;11(10):2609. doi: 10.3390/biomedicines11102609.
Endometriosis, an intriguing gynecological illness, poses a substantial health concern for women of reproductive age, despite its widespread occurrence and limited comprehension. The objective of this study is to assess the diagnostic precision of transvaginal sonography (TVS) and pelvic magnetic resonance imaging (MRI) for the identification of deep infiltrated endometriosis (DIE). This study encompassed a cohort of 256 patients exhibiting signs and symptoms of endometriosis, with the aim of assessing the diagnostic accuracy over a span of four years. Both TVS and pelvic MRI were employed in the same centers to analyze each subject. The histopathologic analysis and laparoscopy were the most reliable and widely accepted methods for evaluation. TVS is a reliable diagnostic tool for ovarian endometriomas, obviating the necessity for MRI confirmation. The specificity of TVS in diagnosing ovarian endometriomas is 57.14%, while its sensitivity is 93.78%, resulting in an overall accuracy of 84.47%. In relation to parametrial lesions, the sensitivity, specificity, and accuracy of TVS and MRI were as follows: TVS: 9%, 97%, 32%, MRI: 27.14%, 89.19%, and 40.11%. Concerning the uterosacral lesions, the sensitivity, specificity, and accuracy of TVS and MRI were as follows: TVS:14.63%, 94.74%, and 55%, while MRI: 65.88%, 66.30%, and 66.1%. Regarding rectal endometriosis, the sensitivity, specificity, and accuracy of TVS and MRI were as follows: 69.72%, 76.87%, and 73.82% for TVS, and 66.28%, 94.51%, and 80.79% for MRI. The results of the present study indicate that whereas MRI generally exhibits superior capability in assessing the severity of endometriosis, TVS demonstrates sufficient diagnostic accuracy in DIE comparable to MRI.
子宫内膜异位症是一种引人关注的妇科疾病，尽管其发病率很高且人们对它的了解有限，但它对育龄女性的健康构成了重大威胁。本研究的目的是评估经阴道超声检查（TVS）和盆腔磁共振成像（MRI）对深部浸润性子宫内膜异位症（DIE）的诊断准确性。本研究纳入了256名有子宫内膜异位症体征和症状的患者，旨在评估四年间的诊断准确性。在同一中心对每位受试者同时采用TVS和盆腔MRI进行分析。组织病理学分析和腹腔镜检查是评估最可靠且被广泛接受的方法。TVS是诊断卵巢子宫内膜异位囊肿的可靠工具，无需MRI确认。TVS诊断卵巢子宫内膜异位囊肿的特异性为57.14%，敏感性为93.78%，总体准确率为84.47%。对于宫旁病变，TVS和MRI的敏感性、特异性和准确率如下：TVS分别为9%、97%、32%；MRI分别为27.14%、89.19%、40.11%。对于子宫骶骨病变，TVS和MRI的敏感性、特异性和准确率如下：TVS分别为14.63%、94.74%、55%；MRI分别为65.88%、66.30%、66.1%。对于直肠子宫内膜异位症，TVS和MRI的敏感性、特异性和准确率如下：TVS分别为69.72%、76.87%、73.82%；MRI分别为66.28%、94.51%、80.79%。本研究结果表明，虽然MRI在评估子宫内膜异位症的严重程度方面通常表现出更强的能力，但TVS在DIE方面显示出与MRI相当的足够诊断准确性。
