Fedele L, Bianchi S, Portuese A, Borruto F, Dorta M
Department of Obstetrics and Gynecology, University of Verona, Italy.
Obstet Gynecol. 1998 Mar;91(3):444-8. doi: 10.1016/s0029-7844(97)00688-1.
To evaluate the validity of transrectal ultrasonography in the assessment of rectovaginal endometriosis.
We compared the findings of transrectal ultrasonographic examination performed before surgery with the operative and pathologic findings in 140 women who underwent laparoscopy or laparotomy for suspected endometriosis. The ultrasonographer was asked to investigate whether any deep endometriotic lesions were present in the rectovaginal septum and to define the lateral extension on the basis of involvement of the uterosacral ligaments. In addition, infiltration of the rectal and vaginal walls was evaluated.
Thirty-four women had endometriosis infiltrating the rectovaginal septum confirmed by combined operative and pathologic findings. Ultrasonography showed a sensitivity and specificity of 97% and 96%, respectively, in the diagnosis of the presence of rectovaginal endometriosis. The sonographer identified infiltration of the rectal and vaginal walls correctly in all cases in whom it was present, but also reported rectal infiltration in three cases not confirmed by the surgeon and pathologist. The sensitivity and specificity in the diagnosis of uterosacral ligament infiltration were 80% and 97%, respectively.
If our preliminary results are confirmed by a larger series, transrectal ultrasonography will be considered a valid diagnostic tool in the evaluation of rectovaginal endometriosis.
评估经直肠超声检查在评估直肠阴道子宫内膜异位症中的有效性。
我们将140例因疑似子宫内膜异位症接受腹腔镜或剖腹手术的女性患者术前经直肠超声检查结果与手术及病理结果进行了比较。要求超声检查者探查直肠阴道隔是否存在任何深部子宫内膜异位病变，并根据子宫骶韧带受累情况确定侧向延伸范围。此外，还评估了直肠壁和阴道壁的浸润情况。
34例患者经手术和病理联合检查证实存在浸润直肠阴道隔的子宫内膜异位症。超声检查在诊断直肠阴道子宫内膜异位症方面的敏感性和特异性分别为97%和96%。超声检查者在所有存在直肠壁和阴道壁浸润的病例中均正确识别，但在3例未得到外科医生和病理学家证实的病例中也报告了直肠浸润。子宫骶韧带浸润诊断的敏感性和特异性分别为80%和97%。
如果我们的初步结果能被更大规模的研究证实，经直肠超声检查将被视为评估直肠阴道子宫内膜异位症的有效诊断工具。
