Accuracy of Five Different Diagnostic Techniques inMild-to-Moderate Pelvic Inflammatory Disease

[摘要] Objective:To evaluate the clinical diagnosis of pelvic inflammatory disease (PID) compared with the diagnosis ofPID made by laparoscopy, endometrial biopsy, transvaginal ultrasound, and cervical and endometrial cultures.Study design:A diagnostic performance test study was carried out by cross-sectional analysis in 61 women. Agroup presenting PID (n= 31) was compared with a group (n=30) presenting another cause for non-specificlower abdominal pain (NSLAP). Diagnosis provided by an evaluated method was compared with a standarddiagnosis (by surgical findings, histopathology, and microbiology). The pathologist was unaware of the visualfindings and presumptive diagnoses given by other methods.Results:All clinical and laboratory PID criteria showed low discrimination capacity. Adnexal tenderness showedthe greatest sensitivity. Clinical diagnosis had 87% sensitivity, while laparoscopy had 81% sensitivity and 100%specificity; transvaginal ultrasound had 30% sensitivity and 67% specificity; and endometrial culture had 83%sensitivity and 26% specificity.Conclusions:Clinical criteria represent the best diagnostic method for discriminating PID. Laparoscopy showedthe best specificity and is thus useful in those cases having an atypical clinical course for discarding abdominalpain when caused by another factor. The other diagnostic methods might have limited use.

[学科分类] 妇产科学