Accuracy of transvaginal and transrectal ultrasounds in the diagnosis of endometriosis: A retrospective cohort study

Background: Early diagnosis and appropriate treatment of endometriosis are vital and may prevent subsequent complications. Objective: To investigate the diagnostic accuracy of transvaginal ultrasound sonography (TVUS) and transrectal ultrasound sonography for detecting endometriosis considering the age and body mass index (BMI). Materials and Methods: This was a retrospective cohort study of ۱۱۹ women scheduled for surgery in a tertiary health care center for clinically suspected endometriosis. Married and virgin women underwent TVUS and transrectal ultrasound sonography, respectively, before laparoscopic excision of endometriotic lesions. Results: The accuracy of TVUS in the diagnosis of right endometrioma in women with a normal BMI was superior to that in women with a BMI ≥ ۳۰ (۹۵.۶% vs. ۷۵.۳%; p < ۰.۰۰۱). For the detection of left endometrioma in women with a normal BMI, TVUS demonstrated a sensitivity of ۹۶.۹% and a negative predictive value of ۹۲.۹%, which was significantly superior to TVUS in women with obesity (sensitivity: ۷۷.۴%, negative predictive value: ۵۸.۶%). The accuracy of TVUS in the diagnosis of left endometrioma in women under ۳۵ yr was superior to that in women older than ۳۵ yr (۹۳.۲% vs. ۷۷.۹%; p = ۰.۰۴). Similarly, the accuracy of TVUS in the diagnosis of right endometrioma in women under ۳۵ yr was superior to TVUS in women older than ۳۵ yr (۸۶.۵% vs. ۷۳.۳%; p = ۰.۰۴). Conclusion: Ultrasound can be a useful technique for detecting endometriosis when used adjunctively with the patient’s history and physical findings, especially age and BMI.

Keywords:

Endometriosis , Ultrasonography , Diagnostic imaging , Body mass index. , آندومتریوز , آندومتریوز عمیقا نفوذ کننده , سونوگرافی ترانس واژینال , سونوگرافی.