GynecologyGynecology2079-56962079-5831Consilium Medicum3011710.26442/2079-5696_2018.5.52-55Research ArticleTransvaginal echography in the diagnosis of localization foci of deep infiltrative endometriosisSaidDanesh Sh-ChupryninV Dv_chuprynin@oparina4.ruGusA I-LunkovS Sl_lunkov@oparina4.ruMelnikovM Vm_melnikov@oparina4.ruAsaturovaA Va_asaturova@oparina4.ruBuralkinaN Anatalyaburalkina@yandex.ruI.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian FederationV.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation15102018205525509042020Copyright © 2018, Consilium Medicum2018The goal is to assess the sensitivity and specificity of transvaginal ultrasound (USI) in the diagnosis of localization of foci of deep infiltrative endometriosis. Materials and methods. The study included 142 patients with deep infiltrative endometriosis, who underwent surgery in the surgical department of the V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russian Federation in the period 2014-2016. Criteria for inclusion in the study: informed agreement of the patient, the reproductive age (from 18 to 44 years), deep infiltrative endometriosis with a confirmed histological conclusion. Exclusion criteria were malignant tumors of the pelvis and abdomen, refusal to undergo surgical treatment of deep infiltrative endometriosis, and malformations of the urogenital system. Results. Transvaginal echography in identifying the localization of foci of deep infiltrative endometriosis is highly sensitive in the diagnosis of colorectal endometriosis (88.9%) and endometriosis of the bladder (96%) with a relatively low specificity of the study (35%). The sizes of endometrial infiltrates of the intestine, retrocervical endometriosis, and bladder intraoperatively were large in comparison with the data obtained with transvaginal ultrasound. When assessing the accuracy of the diagnostic method, it was found that transvaginal ultrasound evaluates retrocervical endometriosis with an accuracy of 41.5%, endometriosis of the intestine - 37.7%, bladder - 54.8%. Conclusion. Transvaginal echography, based on a quantitative assessment of the characteristic curve by calculating the area under it, the size of the infiltrate and their localization, showed that our study have middle diagnostic quality and visualization of DIE lesions with enough specify.transvaginal ultrasounddeep infiltrative endometriosisendometrioid heterotopiaretrocervical endometriosisbladder endometriosisintestinal endometriosisтрасвагинальное ультразвуковое исследованиеглубокий инфильтративный эндометриозэндометриоидные гетеротопииретроцервикальный эндометриозэндометриоз мочевого пузыряколоректальный эндометриоз[Гинекология. Национальное руководство. Под ред. В.И.Кулакова, И.Б.Манухина, Г.М.Савельевой. М: ГЭОТАР-Медиа, 2007.][Chapron C, Fauconnier A, Vieira M et al. Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification. Hum Reprod 2003; 18 (1): 157-61.][Koninckx P, Ussia A. Centers of excellence in endometriosis surgery or "centers of excellence in endometriosis". Gynecol Surg 2009; 7 (2): 109-11.][Chapron C. Глубокий инфильтрирующий эндометриоз: диагностика и терапевтические стратегии. Репродуктивная эндокринология. 2011; 1: 70-6][Эндометриоз: диагностика, лечение и реабилитация. Клинические рекомендации по ведению больных. Под ред. Л.В.Адамян. 2013.][Ищенко А.И., Кудрина Е.А. Эндометриоз: современные аспекты патогенеза, диагностики и лечения. Вопр. гинекологии, акушерства и перинатологии. 2003; 2: 68-73.][Попов А.А., Рамазанов М.Р., Мананникова Т.Н. и др. Хирургическая тактика при инфильтративных формах эндометриоза в репродуктивном возрасте. Рос. вестн. акушера-гинеколога. 2011; 4.][Баскаков В.П. Клиника и лечение эндометриоза. Л.: Медицина, 1990][Ищенко А.И., Кудрина Е.А. Эндометриоз. Диагностика и лечение. М.: ГЭОТАР-МЕД, 2002][Ярмолинская М.И., Айламазян Э.К. Генитальный эндометриоз. Различные грани проблемы. СПб.: Эко-Вектор, 2017.][Wong F.W, Lim C.E, Karia S et al. Cervical endometriosis: case series and review of literature. J Obstet Gynaecol Res 2010; 36: 916-9.][Roman H, Vassilieff M, Gourcerol G et al. Surgical management of deep infiltrating endometriosis of the rectum: pleading for a symptom-guided approach. Hum Reprod 2011; 26 (2): 274-81.][Guerriero S, Ajossa S, Minguez J.A. et al. Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in uterosacral ligaments, rectovaginal septum, vagina and bladder: systematic review and meta-analysis. Alcazar Ultrasound Obstet Gynecol 2015; 46: 534-45.][Румянцев П.О., Саенко В.А., Румянцева У.В., Чекин С.Ю. Статистические методы анализа в клинической практике. Ч. 2. Анализ выживаемости и многомерная статистика. Проблемы эндокринологии. 2009; 55 (6): 48-56.]