caa a22 4500 605493936 CHVBK 20210128100523.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00261-014-0243-5 doi (NATIONALLICENCE)springer-10.1007/s00261-014-0243-5 Routine vs. expert-guided transvaginal ultrasound in the diagnosis of endometriosis: A retrospective review [Elektronische Daten] [Margaret Fraser, Sugandha Agarwal, Innie Chen, Sukhbir Singh] Objective: The objective of this study is to evaluate the sensitivity of routine trans vaginal ultrasound (TVUS) compared to expert-guided transvaginal ultrasound (ETVUS) for the diagnosis of endometriosis. Methods: A retrospective chart review performed at a Canadian tertiary center specializing in the diagnosis and management of endometriosis. All cases with surgically confirmed endometriosis and an ETVUS completed at a single center were included for review and compared to routine TVUS performed for the same indication. Results: Forty cases met the inclusion criteria. Mean patient age of the study population at first surgical diagnosis was 31.2±6.9years. Dysmenorrhea (76.9%) and chronic pelvic pain (74.3%) were the most common presenting symptoms. Sensitivity of routine TVUS was 25% (10/40), compared to 78% (31/40) with ETVUS, (P<0.01). Comparisons were made based on site of disease. Routine TVUS and ETVUS detected bladder involvement in (0/40) vs. 5% (2/40); ureter (0/40) vs. 7.5% (3/40); ovary 25% (10/40) vs. 72.5% (29/40); retrocervical area (0/40) vs. 60% (24/40), rectosigmoid 5% (2/40) vs. 77.5% (31/40), respectively. Specific endometriotic lesions recognized by TVUS versus ETVUS, were: ovarian endometriomas in 25% (10/40) vs. 45% (18/40), adhesions leading to abnormal anatomy in 2.5% (1/40) vs. 77.5% (31/40); endometriotic implants or plaques in 2.5% (1/40) vs. 70% (28/40); and endometriotic nodules in 2.5% (1/40) vs. 35% (14/40), respectively. Routine TVUS diagnosis relied on the presence or absence of endometrioma (10/10), whereas ETVUS showed additional sites of disease in 97% (30/31) patients. Conclusions: ETVUS is more sensitive than routine TVUS to diagnose endometriosis, identifying lesions other than endometrioma and is of assistance in surgical planning and patient counseling. The Author(s), 2014 Diagnosis nationallicence Endometriosis nationallicence Imaging nationallicence Transvaginal ultrasound nationallicence TVUS : Trans vaginal ultrasound nationallicence ETVUS : Expert-guided trans vaginal ultrasound nationallicence Fraser Margaret Department of Medical Imaging, University of Ottawa, 501, Smyth Road, K1H8L6, Ottawa, ON, Canada aut Agarwal Sugandha Department of Obstetrics and Gynecology, University of Ottawa, K1H7W9, Ottawa, ON, Canada aut Chen Innie Clinical Epidemiology Program, Ottawa Hospital Research Institute, K1Y4E9, Ottawa, ON, Canada aut Singh Sukhbir Department of Obstetrics and Gynecology, University of Ottawa, K1H7W9, Ottawa, ON, Canada aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/3(2015-03-01), 587-594 0942-8925 40:3<587 2015 40 261 https://doi.org/10.1007/s00261-014-0243-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0243-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fraser Margaret Department of Medical Imaging, University of Ottawa, 501, Smyth Road, K1H8L6, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Agarwal Sugandha Department of Obstetrics and Gynecology, University of Ottawa, K1H7W9, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Chen Innie Clinical Epidemiology Program, Ottawa Hospital Research Institute, K1Y4E9, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Singh Sukhbir Department of Obstetrics and Gynecology, University of Ottawa, K1H7W9, Ottawa, ON, Canada aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/3(2015-03-01), 587-594 0942-8925 40:3<587 2015 40 261