Clinical significance of diagnostic methods of genital endometriosis


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To determine the clinical significance of methods for diagnosing genital endometriosis. Subjects and methods. The study included 114 patients with external genital endometriosis. All patients were divided into two groups according to the results of surgical treatment. The first group consisted of 65 women without signs of deep infiltrative endometriosis, the second group consisted of 49 patients with deep infiltrative endometriosis. The patients were evaluated with clinical and ultrasound examinations, MRI of the pelvis, colonoscopy, biopsies of rectal mucosa. Results. The prognostic significance of instrumental methods in the diagnosis of various forms of genital endometriosis was determined. The sensitivity of the ultrasound for identifying endometrial cysts was 83.8% and specificity was 76.7%, the accuracy of the method was 95.4%, a positive predictive value was 91.4%, a negative predictive value was 78.7%; all these indicate that it is a sufficiently informative method. To identify infiltration, the sensitivity of the ultrasound was 16.3% and specificity was 56.6%, the accuracy of the method was 701%, a positive predictive value was 100%, the negative predictive value of result was 46.8%. The sensitivity of MRI to identify deep infiltrative endometriosis was 90.9% and specificity was 78.2%, the accuracy of the method amounted 76.9%, a positive predictive value was 95.6%, the negative predictive value of the result was 78.1%. Conclusion. The diagnosis of genital endometriosis, especially infiltrative forms requires special training of doctors, which could allow them to determine the degree of damage to the pelvic organs and to plan the adequate amount of surgery.

Full Text

Restricted Access

About the authors

Sergej V. Barinov

Omsk State Medical University of Ministry of health of the Russian Federation

Email: barinov_omsk@mail.ru
MD, professor, head of the Department of Obstetrics and Gynecology № 2

Oksana V. Lazareva

Omsk State Medical University of Ministry of health of the Russian Federation

Email: lazow@mail.ru
PhD, assistant of the department of obstetrics and gynecology № 2

Yuri A. Ignatyev

Omsk State Medical University of Ministry of health of the Russian Federation

Email: ogma.ray@rambler.ru
MD, professor, head of the Department of Radiodiagnosis

Vladimir L. Poluektov

Omsk State Medical University of Ministry of health of the Russian Federation

Email: 4izzy@mail.ru
MD, professor, head of the Department of Surgery

Sergey I. Mozgovoy

Omsk State Medical University of Ministry of health of the Russian Federation

Email: simozgovoy@yandex.ru
MD, professor of the Department of Pathological anatomy with the course of clinical pathology

Inna V. Shamina

Omsk State Medical University of Ministry of health of the Russian Federation

Email: innadocsever@rambler.ru
PhD, docent, assistant of professor at the Department of Obstetrics and Gynecology № 2

Inna 0. Ledovskih

Omsk Regional Clinical Hospital

Email: innaledo@mail.ru
doctor of ultrasonic diagnostics of the Department of Reproductive and Perinatal Medicine

Lyudmila L. Shkabarnya

Omsk Regional Clinical Hospital

Email: l_shka@mail.ru
head of the Bepartment of gynecology

Vladimir V. Poluektov

Omsk Regional Clinical Hospital

Email: 4izzy@mail.ru
doctor-proctologist of the Department of Proctology

Ksenia G. Ovchinnikova

Omsk State Medical University of Ministry of health of the Russian Federation

Email: ksyu.ov4innikova.90@mail.ru
doctor resident of the department of obstetrics and gynecology № 2

References

  1. Адамян Л.В. Эндометриоз: диагностика, лечение, реабилитация. Клинические рекомендации. М.; 2013. 86с.
  2. Попов A.A., Слободянюк Б.А., Мананникова Т.Н., Федоров А.А., Чантурия Т.З., Барто Р.А. Роль ретроцервикального эндометриоза в генезе бесплодия. Клинический случай и обзор литературы. Русский медицинский журнал. 2014; 229140: 1070-1.
  3. Alborzi S., Rasekhi A., Shomali Z., Madadi G., Alborzi М., Kazemi М., Hosseini Nohandani A. Diagnostic accuracy of magnetic resonance imaging, transvaginal, and transrectal ultrasonography in deep infiltrating endometriosis. Medicine (Baltimore). 2018; 97(8): e9536.
  4. Bazot М., Darai E. Diagnosis of deep endometriosis: clinical examination, ultrasonography, magnetic resonance imaging, and other techniques. Fertil. Steril. 2017; 108(6): 886-94.
  5. Chapron C., Tosti C., Marcellin L., Bourdon М., Lafay-Pillet M.C., Millischer A.E. et al. Relationship between the magnetic resonance imaging appearance of adeno-myosis and endometriosis phenotypes. Hum. Reprod. 2017; 32(7): 1393-401.
  6. Perandini A., Perandini S., Montemezzi S., Bonin C., Bellini G., Bergamini V. Defining probabilities of bowel resection in deep endometriosis of the rectum: Prediction with preoperative magnetic resonance imaging. J. Obstet. Gynaecol. Res. 2018; 44(2): 292-7.
  7. The American Fertility Society. Classification of endometriosis. Fertil. Steril. 1979; 32(5-6): 633-4.
  8. Piessens S., Healey М., Maher P., Tsaltas J., Rombauts L. Can anyone screen for deep infiltrating endometriosis with transvaginal ultrasound? A.N.Z. J. Obstet. Gynecol. 2014; 54(5): 462-8.
  9. Eisenberg V.H., Alcazar J.L., Arbib N., Schiff E., Achiron R., Goldenberg М., Soriano D. Applying a statistical method in transvaginal ultrasound training: lessons from the learning curve cumulative summation test (LC-CUSUM) for endometriosis mapping. Gynecol. Surg. 2017; 14(1): 19. doi: 10.1186/sl0397-017-1022-4.
  10. Guerriero S., Alcazar J.L., Pascual M.A., Ajossa S., Perniciano М., Piras A. et al. Deep infiltrating endometriosis: comparison between 2-dimensional ultrasonography (US), 3-dimensional US, and magnetic resonance imaging. J. Ultrasound Med. 2018; 37(6): 1511-21.
  11. Thalluri A.L., Knox S., Nguyen T. MRI findings in deep infiltrating endometriosis: A pictorial essay. J. Med. Imaging Radiat. Oncol. 2017; 61(6): 767-73. doi: 10.1111/1754-9485.12680.
  12. Donnez O., Roman H. Choosing the right surgical technique for deep endometriosis: shaving, disc excision, or bowel resection? Fertil. Steril. 2017; 108(6): 931-42. doi: 10.1016/j.fertnstert.2017.09.006.
  13. Badescu A., Roman H., Barsan I., Soldea V., Nastasia S., Aziz M. et al. Patterns of bowel invisible microscopic endometriosis reveal the goal of surgery removal of visual lesions only. J. Minim. Invasive Gynecol. 2018; 25(3): 522-7. e9.
  14. Darai E., Bendifallah S., Chabbert-Buffet N., Golfier F. Creation of expert centers on endometriosis. Presse Med. 2017; 46(12, Pt 1): 1218-22.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies