Importance-of-the-ultrasonography-with-bowel-preparation

IMPORTANCE OF THE ULTRASONOGRAPHY WITH BOWEL PREPARATION
FOR DIAGNOSIS OF DEEPENDOMETRIOSIS
Abstract ID : 1767
Soumis par : Mauricio Abrao Le 2016-03-18 11:02:30
Nom de la catégorie : SEUD CONGRESS
Typologie : Communication orale / Oral communication
Statut : validé
Autorisation de diffusion : Yes/Oui
------------------------------------OBJECTIVES: To determine the involvement of the most common sites of deep endometriosis (retrocervical,
rectosigmoid, bladder and posterior vaginal fornix), and the efficacy of ultrasound with bowel preparation for the preoperative diagnosis in these specific sites.
DESIGN: A prospective study of patients with clinically suspected endometriosis were submitted to pelvic and
transvaginal ultrasound (PUS-BP and TVUS-BP). Sonographic findings were compared with the surgical anatomic
findings. All specimens were submitted to pathologic exam, that confirm the diagnosis of endometriosis. Sensitivity,
specificity and likelihood ratio were calculated.
MATERIALS AND METHODS: Between May 2013 and September 2015, 130 consecutive patients underwent
laparoscopy and pathological study. Prior to surgery, ultrasound findings of size, number and location of deep
endometriosis lesions were recorded.
RESULTS: One hundred and thirty consecutive patients underwent surgery for endometriosis. The mean age of the
patients was 32,6 years. We not found deep endometriosis in 21 patients. In the other 109 we find deep endometriosis
with the following incidence by site: retrocervical: 95 patients (87,6 %); rectosigmoid: 55 patients (50,46 %) ; vagina: 18
patients (16,5 %); bladder: 5 patients (4,6 %) and rectovaginal septum: 3 (2,7 %). Several patients had more than one
site compromised.
PUS-BP with TVUS-BP had sensitivity and specificity as follows: 96,9% and 100% for retrocervical; 100% and 98,6% for
rectosigmoid, 100% and 98,2 % for vagina, 100% and 99,2 % for bladder and 100% and 100 % for retovaginal septum.
The value of the positive likelihood ratio ( LR + ) and negative likelihood ratio ( LR - ) are: ? and 0,03 for retrocervical;
71,4 and 0,0 for rectosigmoid; 55,5 and 0,0 for vagina, 125 and 0,0 for bladder and ? and 0,0 for retovaginal septum .
CONCLUSION: These findings show that ultrasound with bowel preparation is an excellent imaging exam for the
diagnosis of deep endometriosis, confirming the usability of this method for pre-operative diagnosis and mapping this
complex disease.
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Auteurs :
Références : , , ,
Auteurs
Manoel OC Goncalves 1, Leandro A Mattos 1, Sergio Podgaec 2, Rosanne Kho 3, Mauricio S Abrao 2,
1. RDO Medical Diagnosis, São Paulo, BRAZIL
2. Department of Obstetrics and Gynecology, University of São Paulo Medical School, São Paulo, BRAZIL
3. Gyn & Women's Health Institute, Cleveland Clinic OH, Cleveland, UNITED STATES
Auteurs (raw format)
Goncalves Manoel OC - email : [email protected] Etablissement : RDO Medical Diagnosis Service : Ville : São Paulo
Pays : BRAZIL Présentateur : Oui
Mattos Leandro A - email : [email protected] Etablissement : RDO Medical Diagnosis Service : Ville : São Paulo Pays
: BRAZIL Présentateur : Non
Podgaec Sergio - email : [email protected] Etablissement : University of São Paulo Medical School Service :
Department of Obstetrics and Gynecology Ville : São Paulo Pays : BRAZIL Présentateur : Non
Kho Rosanne - email : [email protected] Etablissement : Gyn & Women's Health Institute, Cleveland Clinic OH
Service : Ville : Cleveland Pays : UNITED STATES Présentateur : Non
Abrao Mauricio S - email : [email protected] Etablissement : University of São Paulo Medical School Service :
Department of Obstetrics and Gynecology Ville : São Paulo Pays : BRAZIL Présentateur : Non