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- Title
Diagnostic accuracy of transvaginal ultrasound for non-invasive diagnosis of bowel endometriosis: systematic review and meta-analysis.
- Authors
Hudelist, G.; English, J.; Thomas, A. E.; Tinelli, A.; Singer, C. F.; Keckstein, J.
- Abstract
Objective To critically analyze the diagnostic value of transvaginal sonography (TVS) for non-invasive, presurgical detection of bowel endometriosis. Methods MEDLINE(1966-2010) and EMBASE(1980- 2010) databases were searched for relevant studies investigating the diagnostic accuracy of TVS for diagnosing deep infiltrating endometriosis involving the bowel. Diagnosis was established by laparoscopy and/or histopathological analysis. Likelihood ratios (LRs) were recalculated in addition to traditional measures of effectiveness. Results Out of 188 papers, a total of 10 studies fulfilled predefined inclusion criteria involving 1106 patients with suspected endometriosis. The prevalence of bowel endometriosis varied from 24 to 73.3%. LR+ranged from 4.8 to 48.56 and LR-ranged from 0.02 to 0.36, with wide confidence intervals. Pooled estimates of sensitivities and specificities were 91 and 98%; LR+ and LR- were 30.36 and 0.09; and positive and negative predictive values were 98 and 95%, respectively. Three of the studies used bowel preparations to enhance the visibility of the rectal wall; one study directly compared the use of water contrast vs. no prior bowel enema, for which the LR- was 0.04 and 0.47, respectively. Conclusions TVS with or without the use of prior bowel preparation is an accurate test for non-invasive, presurgical detection of deep infiltrating endometriosis of the rectosigmoid.
- Subjects
DIAGNOSIS of endometriosis; MEDICAL imaging systems; TRANSVAGINAL ultrasonography; ENEMA; IRRIGATION (Medicine)
- Publication
Ultrasound in Obstetrics & Gynecology, 2011, Vol 37, Issue 3, p257
- ISSN
0960-7692
- Publication type
Article
- DOI
10.1002/uog.8858