The Performance of the Uterine Artery Resistance Index following Stimulation of the Cervix in the Diagnosis of Endometriosis: A Prospective Study
Background: We speculated that stimulating the uterine cervix of patients may increase blood flow resistance of the uterine artery more significantly in women with endometriosis than those without. Accordingly, the resistance index (RI) of the uterine artery following stimulation of the cervix may o...
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| Format: | Article |
| Language: | English |
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IMR Press
2022-08-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/49/9/10.31083/j.ceog4909190 |
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| author | Su-Hong Jia Hong Sun Ying Wei Qi Ma Qiong-Zhen Ren Min-Fang Shao Yu-Ma Jin Yuan Xie |
| author_facet | Su-Hong Jia Hong Sun Ying Wei Qi Ma Qiong-Zhen Ren Min-Fang Shao Yu-Ma Jin Yuan Xie |
| author_sort | Su-Hong Jia |
| collection | DOAJ |
| description | Background: We speculated that stimulating the uterine cervix of patients may increase blood flow resistance of the uterine artery more significantly in women with endometriosis than those without. Accordingly, the resistance index (RI) of the uterine artery following stimulation of the cervix may offer a novel and promising non-invasive method for diagnosing endometriosis. In this prospective study, the aim was to determine the performance of the uterine artery resistance index (RI) following stimulation of the cervix in the diagnosis of endometriosis. Methods: This prospective cohort study included 270 patients with non-uterine diseases who were scheduled for laparoscopic surgery. Each patient underwent Doppler sonography for peak systolic velocity (PSV), end diastolic velocity (EDV), and RI before and after stimulation of the cervix, in addition to conventional ultrasound examination one day prior to laparoscopic surgery. The cervix was stimulated using a double convex array electronic vaginal probe for real-time tissue elastography. Results: Laparoscopic surgical evaluation revealed endometriosis in 91 (33.7%) patients. Following stimulation of the cervix, the RI of the uterine artery was significantly increased in the endometriosis group (p = 0.00), but no significant increase in the RI was observed in the control group (p = 0.45). The sensitivity and specificity of the post-stimulation RI for diagnosing endometriosis (using a cut off of 0.83) were 85.71% (95% confidence interval (CI): 76.45–91.88) and 88.83% (95% CI: 83.05–92.87), respectively. For peritoneal endometriosis (PEM), sensitivity and specificity were 86.96% (95% CI: 65.33–96.57) and 88.83% (95% CI: 83.05–92.87), respectively. The sensitivity and specificity of transvaginal ultrasonography (TVU) for diagnosing endometriosis were 63.74% (95% CI: 52.93–73.37) and 94.41% (95% CI: 89.68–97.14), respectively. The positive rate for TVU in diagnosing all endometrioses was 63.7%, and this was lower than that for the post-stimulation RI (84.6%, p = 0.001). Conclusions: Stimulation of the cervix leads to a significant decrease in uterine blood perfusion in women with endometriosis. TVU is a sensitive and specific method for the diagnosis of endometrioma, while the RI is a more sensitive parameter for diagnosing PEM than TVU. For the diagnosis of endometriosis, especially for PEM, the post-stimulation RI may prove to be a promising non-invasive diagnostic technique. |
| first_indexed | 2024-04-12T18:18:26Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 0390-6663 |
| language | English |
| last_indexed | 2024-04-12T18:18:26Z |
| publishDate | 2022-08-01 |
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| spelling | doaj.art-0eea2e743c7848e29584ce53e0f7cc172022-12-22T03:21:31ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-08-0149919010.31083/j.ceog4909190S0390-6663(22)01774-2The Performance of the Uterine Artery Resistance Index following Stimulation of the Cervix in the Diagnosis of Endometriosis: A Prospective StudySu-Hong Jia0Hong Sun1Ying Wei2Qi Ma3Qiong-Zhen Ren4Min-Fang Shao5Yu-Ma Jin6Yuan Xie7Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, 215004 Suzhou, Jiangsu, ChinaDepartment of Chinese Medicine, The Second Affiliated Hospital of Soochow University, 215004 Suzhou, Jiangsu, ChinaDepartment of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, 215004 Suzhou, Jiangsu, ChinaDepartment of Ultrasonography, The Second Affiliated Hospital of Soochow University, 215004 Suzhou, Jiangsu, ChinaDepartment of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, 215004 Suzhou, Jiangsu, ChinaDepartment of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, 215004 Suzhou, Jiangsu, ChinaDepartment of Ultrasonography, The Second Affiliated Hospital of Soochow University, 215004 Suzhou, Jiangsu, ChinaDepartment of Chinese Medicine, The Second Affiliated Hospital of Soochow University, 215004 Suzhou, Jiangsu, ChinaBackground: We speculated that stimulating the uterine cervix of patients may increase blood flow resistance of the uterine artery more significantly in women with endometriosis than those without. Accordingly, the resistance index (RI) of the uterine artery following stimulation of the cervix may offer a novel and promising non-invasive method for diagnosing endometriosis. In this prospective study, the aim was to determine the performance of the uterine artery resistance index (RI) following stimulation of the cervix in the diagnosis of endometriosis. Methods: This prospective cohort study included 270 patients with non-uterine diseases who were scheduled for laparoscopic surgery. Each patient underwent Doppler sonography for peak systolic velocity (PSV), end diastolic velocity (EDV), and RI before and after stimulation of the cervix, in addition to conventional ultrasound examination one day prior to laparoscopic surgery. The cervix was stimulated using a double convex array electronic vaginal probe for real-time tissue elastography. Results: Laparoscopic surgical evaluation revealed endometriosis in 91 (33.7%) patients. Following stimulation of the cervix, the RI of the uterine artery was significantly increased in the endometriosis group (p = 0.00), but no significant increase in the RI was observed in the control group (p = 0.45). The sensitivity and specificity of the post-stimulation RI for diagnosing endometriosis (using a cut off of 0.83) were 85.71% (95% confidence interval (CI): 76.45–91.88) and 88.83% (95% CI: 83.05–92.87), respectively. For peritoneal endometriosis (PEM), sensitivity and specificity were 86.96% (95% CI: 65.33–96.57) and 88.83% (95% CI: 83.05–92.87), respectively. The sensitivity and specificity of transvaginal ultrasonography (TVU) for diagnosing endometriosis were 63.74% (95% CI: 52.93–73.37) and 94.41% (95% CI: 89.68–97.14), respectively. The positive rate for TVU in diagnosing all endometrioses was 63.7%, and this was lower than that for the post-stimulation RI (84.6%, p = 0.001). Conclusions: Stimulation of the cervix leads to a significant decrease in uterine blood perfusion in women with endometriosis. TVU is a sensitive and specific method for the diagnosis of endometrioma, while the RI is a more sensitive parameter for diagnosing PEM than TVU. For the diagnosis of endometriosis, especially for PEM, the post-stimulation RI may prove to be a promising non-invasive diagnostic technique.https://www.imrpress.com/journal/CEOG/49/9/10.31083/j.ceog4909190transvaginal ultrasonographycervix stimulationresistance indexdiagnosisendometriosis |
| spellingShingle | Su-Hong Jia Hong Sun Ying Wei Qi Ma Qiong-Zhen Ren Min-Fang Shao Yu-Ma Jin Yuan Xie The Performance of the Uterine Artery Resistance Index following Stimulation of the Cervix in the Diagnosis of Endometriosis: A Prospective Study Clinical and Experimental Obstetrics & Gynecology transvaginal ultrasonography cervix stimulation resistance index diagnosis endometriosis |
| title | The Performance of the Uterine Artery Resistance Index following Stimulation of the Cervix in the Diagnosis of Endometriosis: A Prospective Study |
| title_full | The Performance of the Uterine Artery Resistance Index following Stimulation of the Cervix in the Diagnosis of Endometriosis: A Prospective Study |
| title_fullStr | The Performance of the Uterine Artery Resistance Index following Stimulation of the Cervix in the Diagnosis of Endometriosis: A Prospective Study |
| title_full_unstemmed | The Performance of the Uterine Artery Resistance Index following Stimulation of the Cervix in the Diagnosis of Endometriosis: A Prospective Study |
| title_short | The Performance of the Uterine Artery Resistance Index following Stimulation of the Cervix in the Diagnosis of Endometriosis: A Prospective Study |
| title_sort | performance of the uterine artery resistance index following stimulation of the cervix in the diagnosis of endometriosis a prospective study |
| topic | transvaginal ultrasonography cervix stimulation resistance index diagnosis endometriosis |
| url | https://www.imrpress.com/journal/CEOG/49/9/10.31083/j.ceog4909190 |
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