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TVUSTransvaginal Ultrasound
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Hudelist et al reported an increase in the sensitivity for ovarian endometriosis that increased from approximately 30% with pelvic examination alone to greater than 96% with pelvic examination plus TVUS. (4) However, this is utilizing TVUS as an anatomic image, which previously had been the mainstay of how it was being performed.
Comparisons of unenhanced TVUS and SIS--both of which may be easily performed in the office and at a much lower cost than MRI have shown the latter technique to be superior for evaluating isthmoceles.
(10) Thus, there is a need for a test that complements TVUS and [beta]-hCG to increase diagnostic accuracy in predicting nonviable pregnancies.
Elevation of serum testosterone, a well-validated diagnostic criterion for PCOS, has been shown to correlate with typical PCOS using TVUS but little is known about how accurately it relates to increased ovarian volume in TAUS, said Dr.
MRI provided supplementary diagnostic information in 44% of patients, provided a diagnostic alternative in 33% of patients, and otherwise called into question the TVUS diagnosis in 11% of patients.
Mary undergoes TVUS with bowel preparation, which reveals a normal uterus and adnexa and the presence of 2 lesions, a 2x1.5-cm retrocervical lesion and a 1.8x2-cm rectosigmoid lesion 9 cm above the anal verge.
Collaborative Trial of Ovarian Cancer Screening) trial, TVUS detected 25 invasive carcinomas but only 12 of those were early-stage disease.
(3) In their investigation, TVUS, SIS, and diagnostic hysteroscopy (DH) were compared with a pathologic specimen of the endometrium used as a gold standard in this patient population.
Although numerous studies have attempted to define the roles of EMB with Pipelle and TVUS, the literature is unclear as to which initial test is preferable.
(See Figure 2.) It provides a good map of the pelvis, but with lower accuracy than TVUS offers in pre dicting the depth of in volvement of a bowel com promised by endometriosis.
TVUS should be the first imaging used to assess pelvic pathology.