Document Detail


Routine vs. expert-guided transvaginal ultrasound in the diagnosis of endometriosis: A retrospective review.
MedLine Citation:
PMID:  25236953     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study is to evaluate the sensitivity of routine trans vaginal ultrasound (TVUS) compared to expert-guided transvaginal ultrasound (ETVUS) for the diagnosis of endometriosis.
METHODS: A retrospective chart review performed at a Canadian tertiary center specializing in the diagnosis and management of endometriosis. All cases with surgically confirmed endometriosis and an ETVUS completed at a single center were included for review and compared to routine TVUS performed for the same indication.
RESULTS: Forty cases met the inclusion criteria. Mean patient age of the study population at first surgical diagnosis was 31.2 ± 6.9 years. Dysmenorrhea (76.9 %) and chronic pelvic pain (74.3 %) were the most common presenting symptoms. Sensitivity of routine TVUS was 25 % (10/40), compared to 78 % (31/40) with ETVUS, (P < 0.01). Comparisons were made based on site of disease. Routine TVUS and ETVUS detected bladder involvement in (0/40) vs. 5 % (2/40); ureter (0/40) vs. 7.5 % (3/40); ovary 25 % (10/40) vs. 72.5 % (29/40); retrocervical area (0/40) vs. 60 % (24/40), rectosigmoid 5 % (2/40) vs. 77.5 % (31/40), respectively. Specific endometriotic lesions recognized by TVUS versus ETVUS, were: ovarian endometriomas in 25 % (10/40) vs. 45 % (18/40), adhesions leading to abnormal anatomy in 2.5 % (1/40) vs. 77.5 % (31/40); endometriotic implants or plaques in 2.5 % (1/40) vs. 70 % (28/40); and endometriotic nodules in 2.5 % (1/40) vs. 35 % (14/40), respectively. Routine TVUS diagnosis relied on the presence or absence of endometrioma (10/10), whereas ETVUS showed additional sites of disease in 97 % (30/31) patients.
CONCLUSIONS: ETVUS is more sensitive than routine TVUS to diagnose endometriosis, identifying lesions other than endometrioma and is of assistance in surgical planning and patient counseling.
Authors:
Margaret Ann Fraser; Sugandha Agarwal; Innie Chen; Sukhbir Sony Singh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-19
Journal Detail:
Title:  Abdominal imaging     Volume:  -     ISSN:  1432-0509     ISO Abbreviation:  Abdom Imaging     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9303672     Medline TA:  Abdom Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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