Multidetector computerized tomography enteroclysis vs. rectal water contrast transvaginal ultrasonography in determining the presence and extent of bowel endometriosis

• Published in: Ultrasound in obstetrics & gynecology 2011-05, Vol.37 (5), p.603-613
• Main Authors: Ferrero, S., Biscaldi, E., Morotti, M., Venturini, P. L., Remorgida, V., Rollandi, G. A., Valenzano Menada, M.
• Format: Article
• Language: English
• Subjects: Administration, Rectal; Adult; Age; Biological and medical sciences; bowel endometriosis; colorectal endometriosis; Computed tomography; diagnosis; Digestive system; Endometriosis; Endometriosis - diagnostic imaging; Female; Female genital diseases; Gynecology; Gynecology. Andrology. Obstetrics; Humans; Inflammatory Bowel Diseases - diagnostic imaging; Intestine; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy; Laparoscopy - methods; Medical sciences; multidetector computerized tomography enteroclysis; Nodules; Non tumoral diseases; Obstetrics; Pain; Prospective Studies; Radiodiagnosis. Nmr imagery. Nmr spectrometry; rectal water contrast; Rectum; Sensitivity and Specificity; Surgery; Tomography, X-Ray Computed; transvaginal ultrasonography; Ultrasonography; Ultrasound; Water
• ISSN: 0960-7692; 1469-0705; 1469-0705
• DOI: 10.1002/uog.8971

Objectives To compare the accuracy of multidetector computerized tomography enteroclysis (MDCT‐e) and rectal water contrast transvaginal ultrasonography (RWC‐TVS) in determining the presence and extent of bowel endometriosis. Methods This prospective study included 96 patients of reproductive age with suspicion of bowel endometriosis. Patients underwent MDCT‐e and RWC‐TVS before operative laparoscopy. Findings of MDCT‐e and RWC‐TVS were compared with histological results. The severity of pain experienced during MDCT‐e and RWC‐TVS was measured by a 10‐cm visual analog scale. Results Fifty‐one patients had bowel endometriotic nodules at surgery. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the diagnosis of rectosigmoid endometriosis were 95.8% (46/48), 100.0% (48/48), 100.0% (46/46), 96.0% (48/50) and 97.9% (94/96) for MDCT‐e and 93.8% (45/48), 97.9% (47/48), 97.8% (45/46), 94.0% (47/50) and 95.8% (92/96) for RWC‐TVS. MDCT‐e was associated with more intense pain than was RWC‐TVS. Conclusions MDCT‐e and RWC‐TVS have similar accuracy in the diagnosis of rectosigmoid endometriosis, but patients tolerate RWC‐TVS better than they do MDCT‐e. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.