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Pelvic inflammatory disease. Endovaginal sonography with laparoscopic correlation
R M Patten1, L M Vincent, P Wolner-Hanssen
1Department of Radiology, University of Washington School of Medicine, Seattle 98104.
Summary
Endo-vaginal ultrasound (EVUS) accurately identifies pelvic inflammatory disease (PID) in fallopian tubes and ovaries but is less sensitive for uterine abnormalities and small fluid collections.
Area of Science:
- Gynecology
- Diagnostic Imaging
- Pelvic Inflammatory Disease
Background:
- Pelvic inflammatory disease (PID) is a serious infection that can lead to infertility.
- Accurate and timely diagnosis is crucial for effective treatment.
Purpose of the Study:
- To evaluate the sensitivity and accuracy of endo-vaginal ultrasound (EVUS) in diagnosing acute pelvic inflammatory disease (PID).
- To correlate EVUS findings with laparoscopic results for uterine and adnexal pathology.
Main Methods:
- Prospective study correlating EVUS findings with laparoscopic results.
- 16 patients with operatively confirmed acute PID were included.
- Sensitivity and accuracy of EVUS for tubal, ovarian, and uterine abnormalities were calculated.
Main Results:
- EVUS demonstrated high sensitivity for inflamed fallopian tubes (93%) and ovaries with peri-ovarian inflammation (90%).
- Overall accuracy for EVUS in predicting tubal and peri-ovarian disease was 93% and 91%, respectively.
- EVUS showed lower sensitivity for uterine abnormalities (25%) and missed small pelvic fluid collections (<20 cc) in 6/9 cases.
Conclusions:
- EVUS is a sensitive and accurate tool for identifying adnexal pathology in acute PID.
- EVUS has limitations in detecting uterine abnormalities and small fluid collections in PID.
- Laparoscopy remains valuable for confirming PID diagnoses when EVUS findings are equivocal or negative despite high clinical suspicion.