title: Diagnosis of colorectal endometriosis: contribution of contrast enhanced MR-colonography.
abstract: OBJECTIVE
  To investigate the contribution of contrast-enhanced MR-colonography (CE-MR-C) for the diagnosis of intestinal endometriosis.
  
  
  METHODS
  One hundred and four women with suspected endometriosis were prospectively enrolled. All patients were subjected to MRI consisting of two phases: pelvic high-resolution MRI (HR-MRI) followed by CE-MR-C after colonic distension using a 1.5-liter water enema and injection of 0.15 ml/kg of 0.5 M gadolinium-DTPA with T1w high-resolution isotropic volume (THRIVE) and balanced turbo field echo (BTFE) images. HR-MRI and CE-MR-C were considered as two datasets, which were independently reviewed by two radiologists with 12 and 2 years' experience respectively. The presence of deep pelvic endometriotic lesions with particular attention to colorectal involvement was recorded.
  
  
  RESULTS
  MRI findings correlated with laparoscopy in all cases. Thanks to CE-MR-C images, sensitivity, specificity, PPV, NPV and accuracy for diagnosis of colorectal endometriosis increased from 76%, 96%, 84%, 93% and 91%, to 95%, 97%, 91%, 99% and 97% for the most experienced radiologist and from 62%, 93%, 72%, 89% and 85%, to 86%, 94%, 82%, 96% and 92% for the less experienced radiologist; moreover, the interobserver agreement increased from 0.63 to 0.80 (Cohen's K test).
  
  
  CONCLUSIONS
  CE-MR-C allows easier recognition of colorectal endometriosis and higher interobserver agreement.
authors.affiliation: Department of Internal Medicine and Public Health (Di.M.I.M.P.)-Section of Diagnostic Imaging, University Hospital "Policlinico", Piazza Giulio Cesare 11, 70124 Bari, Italy. a.scardapane@radiologia.uniba.it
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Scardapane
authors.forename: Stefano
authors.initials: S
authors.lastname: Bettocchi
authors.forename: Filomenamila
authors.initials: F
authors.lastname: Lorusso
authors.forename: Amato Antonio
authors.initials: AA
authors.lastname: Stabile Ianora
authors.forename: Antonella
authors.initials: A
authors.lastname: Vimercati
authors.forename: Oronzo
authors.initials: O
authors.lastname: Ceci
authors.forename: Maurilia
authors.initials: M
authors.lastname: Lasciarrea
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Angelelli
mesh_terms: D000328:Adult; D003108:Colonic Diseases / Q000175:diagnosis* / Q000601:surgery; D003287:Contrast Media; D004715:Endometriosis / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012002:Rectal Diseases / Q000175:diagnosis* / Q000601:surgery; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA