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Counting ovarian antral follicles by ultrasound: a practical guide
Coelho Neto, M. A.; Ludwin, A.; Borrell, A. ...
Ultrasound in obstetrics & gynecology,
January 2018, 2018-01-00, 20180101, Letnik:
51, Številka:
1
Journal Article
Recenzirano
Odprti dostop
ABSTRACT
This Consensus Opinion summarizes the main aspects of several techniques for performing ovarian antral follicle count (AFC), proposes a standardized report and provides recommendations for ...
future research. AFC should be performed using a transvaginal ultrasound (US) probe with frequency ≥ 7 MHz. For training, we suggest a minimum of 20–40 supervised examinations. The operator should be able to adjust the machine settings in order to achieve the best contrast between follicular fluid and ovarian stroma. AFC may be evaluated using real‐time two‐dimensional (2D) US, stored 2D‐US cine‐loops and stored three‐dimensional (3D) US datasets. Real‐time 2D‐US has the advantage of permitting additional maneuvers to determine whether an anechoic structure is a follicle, but may require a longer scanning time, particularly when there is a large number of follicles, resulting in more discomfort to the patient. 2D‐US cine‐loops have the advantages of reduced scanning time and the possibility for other observers to perform the count. The 3D‐US technique requires US machines with 3D capability and the operators to receive additional training for acquisition/analysis, but has the same advantages as cine‐loop and also allows application of different imaging techniques, such as volume contrast imaging, inversion mode and semi‐automated techniques such as sonography‐based automated volume calculation. In this Consensus Opinion, we make certain recommendations based on the available evidence. However, there is no strong evidence that any one method is better than another; the operator should choose the best method for counting ovarian follicles based on availability of resources and on their own preference and skill. More studies evaluating how to improve the reliability of AFC should be encouraged. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Diagnostic accuracy of transvaginal sonography for detecting parametrial involvement in women with deep endometriosis: systematic review and meta‐analysis
Guerriero, S.; Martinez, L.; Gomez, I. ...
Ultrasound in obstetrics & gynecology,
November 2021, 2021-Nov, 2021-11-00, 20211101, Letnik:
58, Številka:
5
Journal Article
Recenzirano
Odprti dostop
ABSTRACT
Objective
To evaluate the accuracy of transvaginal sonography (TVS) for detecting parametrial deep endometriosis, using laparoscopy as the reference standard.
Methods
A search was performed ...
in PubMed/MEDLINE and Web of Science for studies evaluating TVS for detecting parametrial involvement in women with suspected deep endometriosis, as compared with laparoscopy, from January 2000 to December 2020. The Quality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2) tool was used to evaluate the quality of the studies. Pooled sensitivity, specificity and positive and negative likelihood ratios for TVS in the detection of parametrial deep endometriosis were calculated, and the post‐test probability of parametrial deep endometriosis following a positive or negative test was determined.
Results
The search identified 134 citations. Four studies, comprising 560 patients, were included in the analysis. The mean prevalence of parametrial deep endometriosis at surgery was 18%. Overall, the pooled estimated sensitivity, specificity and positive and negative likelihood ratios of TVS in the detection of parametrial deep endometriosis were 31% (95% CI, 10–64%), 98% (95% CI, 95–99%), 18.5 (95% CI, 8.8–38.9) and 0.70 (95% CI, 0.46–1.06), respectively. The diagnostic odds ratio was 26 (95% CI, 10–68). Heterogeneity was high. Visualization of a lesion suspected to be parametrial deep endometriosis on TVS increased significantly the post‐test probability of parametrial deep endometriosis.
Conclusion
TVS has high specificity but low sensitivity for the detection of parametrial deep endometriosis. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Strengths and limitations of diagnostic tools for endometriosis and relevance in diagnostic test accuracy research
Pascoal, E.; Wessels, J. M.; Aas‐Eng, M. K. ...
Ultrasound in obstetrics & gynecology,
September 2022, Letnik:
60, Številka:
3
Journal Article
Recenzirano
Endometriosis is a chronic systemic disease that can cause pain, infertility and reduced quality of life. Diagnosing endometriosis remains challenging, which yields diagnostic delays for patients. ...
Research on diagnostic test accuracy in endometriosis can be difficult due to verification bias, as not all patients with endometriosis undergo definitive diagnostic testing. The purpose of this State‐of‐the‐Art Review is to provide a comprehensive update on the strengths and limitations of the diagnostic modalities used in endometriosis and discuss the relevance of diagnostic test accuracy research pertaining to each. We performed a comprehensive literature review of the following methods: clinical assessment including history and physical examination, biomarkers, diagnostic imaging, surgical diagnosis and histopathology. Our review suggests that, although non‐invasive diagnostic methods, such as clinical assessment, ultrasound and magnetic resonance imaging, do not yet qualify formally as replacement tests for surgery in diagnosing all subtypes of endometriosis, they are likely to be appropriate for advanced stages of endometriosis. We also demonstrate in our review that all methods have strengths and limitations, leading to our conclusion that there should not be a single gold‐standard diagnostic method for endometriosis, but rather, multiple accepted diagnostic methods appropriate for different circumstances. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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