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Table 2 Summary of relevant studies

From: Evidence-based gynaecological practice: clinical review 3. The use of imaging for pre-operative planning in deep infiltrating endometriosis involving the rectum

Author [reference]

Study period

Study population

Age

TVS

TRS

MRI

Blinding

Abrao [10]

2004-2006

104 Consecutive women with clinically suspected endometriosis

Mean 33.8 years (SD 6.1)

HDI 5000 ultrasound scanner with 5-9MHz transducer within 3months before surgery. Rectal enema used

N/A

1.5T scanner with a Torso phase array coil. Contrast agent gadolinium 0.2mmol/kg. No bowel preparation used

TVS carried out blinded to clinical data. MRI radiologist blinded to clinical data and TVS results

Bazot [11]

2000–2004

81 Consecutive women referred for surgical management of DIE

Median 31.9years

Ultramark HDI 5000 or Siemens Elegra ultrasound machine. 5-9MHz transducer. No bowel preparation used

Olympus GF UM 20 Echo endoscope, 7.5 and 12MHz.

 

Sonographers informed of women’s clinical history and symptoms but blinded to physical examination and previous imaging. Different physicians performed TVS and TRS

Bazot [19]

2000–2005

Retrospective study of 92 consecutive women with clinically suspected pelvic endometriosis

Median 31.8years

Ultramark HDI 5000 or Siements Elegra ultrasound machine, 5-9MHz transducer. No bowel preparation used

Olympus GF UM 20 Echo endoscope, 7.5 and 12MHz probe

1.5T scanner. Bowel preparation given. Contrast agent gadolinium

All examinations conducted by different physicians with knowledge of clinical history and symptoms but blind to results of physical exam and other imaging

Chamié [12]

2005-2007

92 Women with a history and clinical examination consistent with endometriosis

Mean 33years

N/A

N/A

GE Signa 1.5T scanner. Contrast agent gadolinium. No bowel preparation used

MRI images interpreted independently by 2 radiologists blinded to patient history

Chapron [13]

 

Retrospective study of 81 consecutive patients with histologically proven DIE. MRI and transrectal ultrasound given prior to planned surgery

Mean 31.0 (SD6.7)

N/A

Olympus GF-UM20 scope ultrasound machine with 7.5 and 12MHz probes

1.5T Tesla Unit with a phased-array coil. No contrast aged used

Patients already had a diagnosis of DIE but the ultrasonographer and radiologist were blind to clinical information when they interpreted the results of the tests

Delpy [14]

1998–2003

31 Women with suspected rectovaginal endometriosis based on clinical symptoms and/or abnormal clinical examination

Mean 31.5years

N/A (for rectal infiltration)

7.5MHz radial-scanning miniprobe (Fujinon) fitted with a distal balloon

N/A

Blind to precise clinical findings but with the knowledge of suspected endometriosis. Surgery conducted with full knowledge of imaging results

Guerriero [15]

2005-2007

88 Consecutive women with clinically suspected endometriosis

Mean 33years (SD 5)

1Week before surgery using Technos MPX with 6.5-7.0MHz transducer. Paid special attention to tender areas. No rectal enema used.

N/A

N/A

Not reported

Hudelist [16]

2007–2008

200 Women with clinically suspected endometriosis

Median 33years

Logic 9 or Accuvix XQ ultrasound machine 5-9MHz transducer combined with bimanual PV examination within 2months of surgery. No rectal enema used

  

PV examination performed first followed by TVS by the same examiner

Menada [17]

2006–2007

90 Women with clinically suspected rectovaginal endometriosis

Median 32years

Siemens Sonoline Antares ultrasound machine. 3.6-8.0MHz multifrequency transducer

   

Given on day of surgery. Bowel preparation given on the day before surgery. Saline solution injected into the rectum during the procedure

N/A

N/A

TVS carried out independently by 2 ultrasonographers with the knowledge of clinically suspected disease by blind to any other clinical information

    

Piketty [18]

2005–2007

134 Women with clinically suspected DIE

Mean 32.1years (SD 5)

Toshiba ultrasound machine. 5-9MHz transducer. No rectal enema used

Olympus UM 160 following rectal enema. 5, 7.5 and 12MHz frequencies used

N/A

Examiners told DIE was suspected but were not given information on clinical findings or other imaging findings