title: Contribution of Computed Tomography Enema and Magnetic Resonance Imaging to Diagnose Multifocal and Multicentric Bowel Lesions in Patients With Colorectal Endometriosis.
abstract: OBJECTIVE
  To evaluate the diagnostic contribution of the computed tomography (CT) enema and magnetic resonance imaging (MRI) for multifocal (multiple lesions affecting the same segment) and multicentric (multiple lesions affecting several digestive segments) bowel endometriosis.
  
  
  METHODS
  Prospective cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  Eighty-five patients.
  
  
  METHODS
  Tenon University Hospital, Paris, France.
  
  
  METHODS
  All patients received a preoperative CT enema and underwent MRI interpreted by 2 radiologists.
  
  
  RESULTS
  Patients underwent colorectal resection for colorectal endometriosis from February 2009 to November 2012. Nineteen patients (22%) had multifocal lesions, and 11 patients (13%) had multicentric lesions. Six patients (7%) had both multifocal and multicentric lesions. The sensitivity, specificity, and positive and negative likelihood ratios (LRs) of MRI for the diagnosis of multifocal lesions were 0.58, 0.84, 3.55, and 0.5, respectively. The sensitivity, specificity, and positive and negative LRs of the CT enema for the diagnosis of multifocal lesions were 0.64, 0.86, 4.56, and 0.4, respectively. The sensitivity, specificity, and positive LR of MRI for the diagnosis of multicentric lesions were 1, 0.88, and 8.4, respectively. The sensitivity, specificity, and positive and negative LRs of MRI for the diagnosis of multicentric lesions were 0.46, 0.92, 5.6, and 0.59, respectively. No difference was observed between MRI and the CT enema for the diagnosis of multifocal and multicentric colorectal endometriosis. The interobserver agreement was good for MRI and the CT enema (κ = 0.45 and 0.45) for multifocality, and it was poor for both MRI and the CT enema (κ = 0.32 and 0.34) for multicentricity.
  
  
  CONCLUSIONS
  Both MRI and the CT enema were able to diagnose multifocal and multicentric bowel endometriosis with similar accuracy.
authors.affiliation: Department of Obstetrics and Gynecology, Tenon Hospital, AP-HP, Paris, France; GRC6-UPMC: Centre expert en Endométriose (C3E), Paris, France.
authors.forename: Jeremie
authors.initials: J
authors.lastname: Belghiti
authors.affiliation: Department of Radiology, Tenon Hospital, AP-HP, Paris, France; GRC6-UPMC: Centre expert en Endométriose (C3E), Paris, France; UMR_S938 Université Pierre et Marie Curie Paris 6, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Thomassin-Naggara
authors.affiliation: Department of Obstetrics and Gynecology, Tenon Hospital, AP-HP, Paris, France; GRC6-UPMC: Centre expert en Endométriose (C3E), Paris, France.
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Zacharopoulou
authors.affiliation: Department of Obstetrics and Gynecology, Tenon Hospital, AP-HP, Paris, France; GRC6-UPMC: Centre expert en Endométriose (C3E), Paris, France.
authors.forename: Sonia
authors.initials: S
authors.lastname: Zilberman
authors.affiliation: Department of Radiology, Tenon Hospital, AP-HP, Paris, France.
authors.forename: Lamia
authors.initials: L
authors.lastname: Jarboui
authors.affiliation: Department of Radiology, Tenon Hospital, AP-HP, Paris, France; GRC6-UPMC: Centre expert en Endométriose (C3E), Paris, France; UMR_S938 Université Pierre et Marie Curie Paris 6, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Bazot
authors.affiliation: Department of Obstetrics and Gynecology, Tenon Hospital, AP-HP, Paris, France; GRC6-UPMC: Centre expert en Endométriose (C3E), Paris, France; UMR_S938 Université Pierre et Marie Curie Paris 6, Paris, France.
authors.forename: Marcos
authors.initials: M
authors.lastname: Ballester
authors.affiliation: Department of Obstetrics and Gynecology, Tenon Hospital, AP-HP, Paris, France; GRC6-UPMC: Centre expert en Endométriose (C3E), Paris, France; UMR_S938 Université Pierre et Marie Curie Paris 6, Paris, France. Electronic address: emile.darai@tnn.aphp.fr.
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
mesh_terms: D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D004715:Endometriosis / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D004733:Enema / Q000379:methods; D005260:Female; D005602:France; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011446:Prospective Studies; D012002:Rectal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D014057:Tomography, X-Ray Computed
keywords: Bowel endometriosis; Colorectal endometriosis; Computed tomography enema; Magnetic resonance imaging