Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Aug 23.
doi: 10.1002/uog.70004. Online ahead of print.

Transvaginal ultrasound for detecting parametrial involvement in suspected deep pelvic endometriosis: updated meta-analysis

J L Alcázar  1 , C Montoya  2 , C Candau  3 , C Catalan  4 , R Orozco  1 , M Á Pascual  5 , S Ajossa  6 , S Guerriero  6
Affiliations
Review

Transvaginal ultrasound for detecting parametrial involvement in suspected deep pelvic endometriosis: updated meta-analysis

J L Alcázar et al. Ultrasound Obstet Gynecol. .

Abstract

Objective: To perform an updated meta-analysis evaluating the diagnostic performance of transvaginal ultrasound (TVS) for detecting lateral parametrial involvement in women with suspected deep pelvic endometriosis.

Methods: A literature search was performed in the Web of Science, PubMed and Scopus databases from January 2021 to May 2024 for studies evaluating TVS for detecting parametrial involvement in women with suspected deep pelvic endometriosis, using laparoscopy with or without histology as the reference standard. The information gathered was combined with data from our previous meta-analysis on this topic. Pooled sensitivity and specificity were calculated overall and for subgroup analyses considering parametrial laterality. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to evaluate study quality.

Results: After exclusions, four new studies fulfilling the selection criteria were identified. Combined with the four studies included in our previous meta-analysis, eight studies including a total of 6728 women (13 456 parametria) were included. The mean prevalence of parametrial involvement was 21.3%. The pooled sensitivity and specificity of TVS for detecting parametrial involvement were 63% (95% CI, 31-86%) and 98% (95% CI, 96-99%), respectively. When considering only the five studies that reported laterality, the corresponding values were 85% (95% CI, 64-95%) and 98% (95% CI, 92-99%) for the left parametrium and 84% (95% CI, 61-94%) and 97% (95% CI, 92-99%) for the right parametrium. Heterogeneity was high for the overall analysis and subgroup analyses.

Conclusions: The diagnostic performance of TVS for detecting parametrial involvement in women with suspected deep pelvic endometriosis is better than that reported previously. This may be attributable to the use of a standardized TVS scanning technique and improved knowledge of pelvic ultrasound anatomy. Accurate parametrial assessment could improve surgical planning and patient outcome. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Keywords: endometriosis; parametrium; transvaginal; ultrasound.

PubMed Disclaimer

Similar articles

See all similar articles

References

REFERENCES

    1. Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;382:1244‐1256.
    1. Piketty M, Chopin N, Dousset B, et al. Preoperative work‐up for patients with deeply infiltrating endometriosis: transvaginal ultrasonography must definitively be the first‐line imaging examination. Hum Reprod. 2009;24:602‐607.
    1. Nisenblat V, Bossuyt PM, Farquhar C, Johnson N, Hull ML. Imaging modalities for the non‐invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016;2:CD009591.
    1. Guerriero S, Saba L, Pascual MA, et al. Transvaginal ultrasound vs magnetic resonance imaging for diagnosing deep infiltrating endometriosis: systematic review and meta‐analysis. Ultrasound Obstet Gynecol. 2018;51:586‐595.
    1. Noventa M, Scioscia M, Schincariol M, et al. Imaging modalities for diagnosis of deep pelvic endometriosis: comparison between trans‐vaginal sonography, rectal endoscopy sonography and magnetic resonance imaging. A head‐to‐head meta‐analysis. Diagnostics (Basel). 2019;9:225.

LinkOut - more resources