To compare the value of physical examination, transvaginal sonography (TVS), rectal
endoscopic sonography (RES), and magnetic resonance imaging (MRI) for the assessment
of different locations of deep infiltrating endometriosis (DIE).
Retrospective longitudinal study.
Tertiary university gynecology unit.
Ninety-two consecutive patients with clinical evidence of pelvic endometriosis.
Physical examination, TVS, RES, and MRI, performed preoperatively.
Descriptive statistics, calculation of likelihood ratios (LR(+) and LR(-)) of physical
examination, TVS, RES, and MRI for DIE in specific locations confirmed by surgery/histology.
The sensitivity and LR(+) and LR(-) values of physical examination, TVS, RES, and
MRI were, respectively, 73.5%, 3.3, and 0.34, 78.3%, 2.34, and 0.32, 48.2%, 0.86,
and 1.16, and 84.4%, 7.59, and 0.18 for uterosacral ligament endometriosis; 50%, 3.88,
and 0.57, 46.7%, 9.64, and 0.56, 6.7%, -, and 0.93, and 80%, 5.51, and 0.23 for vaginal
endometriosis; and 46%, 1.67, and 0.75, 93.6%, -, and 0.06, 88.9%, 12.89, and 0.12,
and 87.3%, 12.66, and 0.14 for intestinal endometriosis.
The MRI performs similarly to TVS and RES for the diagnosis of intestinal endometriosis
but has higher sensitivity and likelihood ratios for uterosacral ligament and vaginal
endometriosis.