O-19: A Comparison of Pelvic Magnetic Resonance Imaging, Trans-Vaginal and Trans-Rectal Sonography with Laparoscopic Findings in The Diagnosis of Deep Infiltrating Endometriosis
The performance of TVS, TRS and MRI for the diagnosis of DIE have been separately reported in earlier studies. However, the three methods have not been concurrently compared in terms of their overall performance and classified results as per different anatomical locations of DIE lesions in a large study population. This study was an attempt to compare pelvic magnetic resonance imaging, trans-vaginal and trans-rectal sonography with laparoscopic findings in the diagnosis of deep infiltrating endometriosis.
Materials and methods
317 patients with endometriosis undergoing operative laparoscopy from March 2010 to December 2014.W omen (mean age 31± 5.4 years) who presented with signs and symptoms of endometriosis and scheduled for operative laparoscopy, underwent pre-operative assessment using pelvic MRI, TVS and TRS. Results were compared with laparoscopy findings. Sensitivity, specificity and accuracy of the three modalities in the diagnosis of DIE lesions were evaluated.
Regardless of anatomical location, TRS possessed a marginally higher sensitivity for the diagnosis of DIE lesions than TVS and MRI (81.12% vs. 80.14% and 77.87%, respectively). However, specificity was slightly higher for MRI as compared to TVS and TRS (97.14% vs 96.65% and 95.77%, respectively). In addition TRS held a similar accuracy compared to TVS and MRI (93.28% vs 93.14% and 92.79%, respectively).
While TVS is amongst the preferred imaging modalities for the pre-operative assessment of DIE lesions, TRS, can be considered as an alternative modality for the diagnosis of DIE. TRS is an alternative imaging in virgin individuals who may not undergo TVS. MRI should be considered as a complementary method when ovarian fossa and ureter are suspected to be involved with DIE.