Evaluation of colonic involvement in endometriosis: double-contrast barium enema vs. magnetic resonance imaging.
BACKGROUND
The purpose of the study was to compare the accuracy of double-contrast barium enema (DCBE) and magnetic resonance imaging (MRI) in the diagnosis of intestinal endometriosis using the histological examination on resected specimen as comparative standard.


METHODS
Eighty-three consecutive patients with suspected intestinal endometriosis, resected between 2005 and 2007, were prospectively evaluated. All of the women underwent preoperative DCBE and MRI on the same day. We evaluated number, site (rectum, sigmoid, cecum), and size of the lesions. The imaging findings were correlated with those resulting at pathology.


RESULTS
Among the 65 women who underwent surgery, 50/65 (76.9%) were found to have bowel endometriosis, with 9/50 (18%) patients presenting two lesions; DCBE allowed to detect 50/59 (84.7%) lesions. MRI allowed to detect 42/59 (71.1%) lesions. DCBE showed sensibility, specificity, PPV, NPV, and accuracy of respectively 84.7, 93.7, 98.0, 62.5, and 86.6%, MRI of 71.1, 83.3, 93.3, 46.8, and 74.6%.


CONCLUSIONS
DCBE is more accurate than unenhanced MRI in the diagnosis of bowel endometriosis, and should be preferred in the preoperative management of this disease, since it usually enables a proper surgical planning.
Faccioli
N
N
Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale Scuro 10, 37134 Verona, Italy. nfaccioli@sirm.org
Foti
G
G
Manfredi
R
R
Mainardi
P
P
Spoto
E
E
Ruffo
G
G
Minelli
L
L
Mucelli
R Pozzi
RP
D000328:Adult; D001466:Barium Sulfate; D003108:Colonic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D004715:Endometriosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D004733:Enema; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D012002:Rectal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D003287:Contrast Media; D001466:Barium Sulfate