[Double-contrast barium enema in the diagnosis of intestinal deeply infiltrating endometriosis].
OBJECTIVE
to evaluate the sensitivity, specificity, positive and negative predictive value of double contrast barium enema (DCBE) for the diagnoses of rectum and sigmoid endometriosis.


METHODS
prospective transversal study including 37 patients with suspicion of deep endometriosis. Patients were submitted to DCBE, according to the standard technique described in the literature, and then, to laparoscopy. The results of laparoscopy and the DCBE images were interpreted and compared, based on the histological evaluation. Statistical analysis was done by association (chi2 test) and agreement analyses (Kappa's test).


RESULTS
patients' average age was 35.8+/-4.4 years old (age group from 28 to 48 years), 85.6% of them being white and 14.4%, black women. Deep endometriosis was confirmed by laparoscopy and histological exam in all the studied patients. Intestinal endometriosis was confirmed by histological exam in 27 women (72.9%) of them. DCBE demonstrated suggestive radiologic signs of intestinal infiltration by endometriosis in 24 women (64.9%) and no signs in 13 women (35.1%). The method sensitivity was 67.5%, specificity 53.8%, positive predictive value, 77.8% and negative predictive value, 70%. Among the 24 abnormal exams, 16 (43.2%) presented radiologic speculum-type image, 16 (43.2%), an image compatible with stenosis, and four (10.8%), double contour.


CONCLUSIONS
the DCBE presents high sensitivity and high positive predictive value, in the diagnosis of the rectum and sigmoid endometriosis. Radiologic images speculum and stenosis-type present high sensitivity and positive predictive value for the intestinal infiltration by endometriosis.
Ribeiro
Helizabet Salomão Abdalla Ayroza
HS
Departamento de Obstetrícia e Ginecologia, Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil. hsaayrozaribeiro@uol.com.br
Ribeiro
Paulo Augusto Ayroza Galvão
PA
Rodrigues
Francisco César
FC
Donadio
Nilson
N
Auge
Antônio Pedro Flores
AP
Aoki
Tsutomu
T
D000328:Adult; D001466:Barium Sulfate; D003287:Contrast Media; D003430:Cross-Sectional Studies; D004715:Endometriosis / Q000175:diagnosis*; D004733:Enema; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012002:Rectal Diseases / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D012810:Sigmoid Diseases / Q000175:diagnosis*
D003287:Contrast Media; D001466:Barium Sulfate