Abstract
BACKGROUND Experts and experience in the medical profession are required for diagnosis of pelvic endometriosis. The objective of this study was to compare the diagnostic parameters of transvaginal ultrasound versus pelvic magnetic resonance imaging (MRI) to diagnose pelvic endometriosis. MATERIAL AND METHODS Our analysis included results of pelvic examinations, pelvic MRI scans, transvaginal ultrasound scans, and laparoscopy and histopathologic evaluation of 144 women who had positive examination results for pelvic endometriosis. RESULTS Transvaginal ultrasound scans had inferior diagnostic parameters and a higher clinical risk of missing pelvic endometriosis than pelvic MRI examinations for pelvic endometriosis. True-positive (45 [83%] vs 47 [86%], P=0.7873), false-positive (4 [7%] vs 2 [4%], P=0.6785), true-negative (3 [6%] vs 3 [6%]), false-negative (2 [4%] vs 2 [4%]), sensitivity (96% vs 96%), and clinical benefits (0-0.92 vs 0-0.921 diagnostic confidence that had beneficial scores to detect biomarker signs in working areas) were identical for the transvaginal ultrasound and the pelvic MRI examinations for hypoechoic solids and/or cysts. Diagnostic parameters and clinical benefits (0-0.75 vs 0-0.918 diagnostic confidence that had beneficial scores to detect biomarker signs in working areas) were inferior to those of transvaginal ultrasound compared to pelvic MRI examinations for uterine enlargement and asymmetry. CONCLUSIONS Transvaginal ultrasound has limited clinical applications compared to pelvic MRI examinations to diagnosis pelvic endometriosis. Except for uterine size and shape, transvaginal ultrasound examinations have sufficient diagnostic parameters to detect pelvic endometriosis in women with clinical manifestations.