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Evaluation and Comparison of the Accuracy of Transvaginal ultrasound and MRI for the diagnosis of deep rectal endometriosis:A cross-sectional study

Int J Gynaecol Obstet. 2022 Nov 4. doi: 10.1002/ijgo.14554. Online ahead of print.


OBJECTIVE: The present research aimed to determine and compare the value of magnetic resonance imaging (MRI) and transvaginal ultrasonography (TVUS) in the diagnosis of rectal endometriosis.

METHODS: In this cross-sectional study, 555 patients with rectal endometriosis, who had undergone MRI and TVUS before laparoscopic operation, were included. The sensitivity, specificity and accuracy of these two imaging modalities were evaluated and compared based on histopathological reports and three different kinds of rectal endometriosis surgeries (shaving as a first group, disc and segmental resection methods as a second group).

RESULTS: Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+) and negative likelihood ratio (LR-) of ultrasound in the diagnosis of rectal endometriosis were respectively 69.55 (65.4-73.4), 91.30 (72-98.9),70.4 (66.4-74.17),11.48 (9.77-13.43),99.46 (98-99.86),8.0 (2.12-30.1) and 0.3 (0.28-0.4). These values were 51.37 (47.1-55.6), 79.17 (57.8-92.9), 52.53 (48.3-56.6), 6.64 (5.39-8.16), 98.26 (96.26-99.2), 2.47 (1.13-5.4) and 0.6 (0.49-077) for MRI. Even though ultrasound had better accuracy for detection of superficial rectal endometriosis (group 1) (P<0.0001), the sensitivity, specificity, and accuracy of both imaging modalities in diagnosis of deep rectal lesions (group 2) were almost identical.

CONCLUSION: TVS should be considered as a first-line modality for RE diagnosis, mainly owing to its greater availability, lower cost, and higher accuracy.

PMID:36333881 | DOI:10.1002/ijgo.14554

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