Comparison of three-dimensional rectosonography, rectal endoscopic sonography and magnetic resonance imaging performances in the diagnosis of rectosigmoid endometriosis

ABSTRACT Study Objective Comparison of 3D-rectosonography (3D-RSG), rectal endoscopic sonography (RES), and MRI performances in the diagnosis of rectosigmoid endometriosis using surgery as the Gold Standard. Design Monocentric retrospective longitudinal study on diagnostic procedures. Design Classification Canadian Task Force II-2 Setting University Hospital of Lyon Croix-Rousse Patients A total of 37 patients treated surgically for pelvic endometriosis. Interventions Expert 3D-RSG (3D Transvaginal sonography with water contrast in the rectum), MRI and RES performed by expert examiners. Sensitivity, specificity, accuracy, positive and negative predictive value, positive and negative likelihood ratios were calculated. Depth, size, and volume of intestinal lesions were also compared to the type of surgery performed (shaving versus segmental resection). Measurements and main results Rectosigmoid endometriosis lesion was confirmed by surgery in 31 patients on 37 (84%). Sensitivity, specificity, accuracy, positive and negative predictive value, positive and negative likelihood ratios for 3D-RSG were 94%, 100%, 95%, 100%, 75%, +∞ and 0.06 respectively; for RES 81 %, 100%, 84%, 100%, 50%, +∞ and 0.19 respectively; while for MRI 90%, 100%, 92%, 100%, 67 %, +∞ and 0,10 respectively. There was no significant difference between the 3 procedures (p > 0.05). Conclusion 3D-RSG, RES and MRI seem to be 3 effective procedures in the diagnosis of rectosigmoid endometriosis. Their performances seem equivalent.