{"paper_id":"66539c5e-be53-4013-aa4b-c7ad34f5e51e","body_text":"ECR 2013 / C-1338\nShould virtual colonoscopy be included in the pre-operative imaging work-up of patients with intestinal endometriosis: A prospective comparative evaluation.\nCongress:\nECR 2013\nPoster Number:\nC-1338\nType:\nScientific Exhibit\nKeywords:\nGastrointestinal tract, Genital / Reproductive system female, CT, Colonography CT, Obstruction / Occlusion\nAuthors:\nC. Da Costa1, H. Roman2, J. van der Wat3, M. Vassilief2, J.-J. Tuech2, C. Martin2, J.-N. Dacher2, C. Savoye-Collet2; 1Le Chesnay/FR, 2Rouen/FR, 3Johannesburg/ZA\nDOI:\n10.1594/ecr2013/C-1338\nPurpose\nManagement of patients with severe intestinal endometriosis remains a therapeutic challenge,\nwhich eventually needs surgery.\nOn one hand,\nsurgical treatment planning requires both precise preoperative location of endometriosis lesions and assessment of intestinal wall or lumen involvements.\nOn the other hand,\nnone of the imaging modalities currently available in the preoperative workup of patients with severe intestinal endometriosis such as endorectal ultrasonography (ERS) and magnetic resonance imaging (MRI) provides complete and accurate evaluation of these features.\nVirtual colonoscopy (VC),\nwhich is routinely used in the...\nMethods and Materials\nPatient selection\nBetween 2009 and 2012,\n77 patients with suspected intestinal endometriosis qualifying for surgery were prospectively enrolled to assess the existence and characterize the type of intestinal involvement on VC.\nOf these,\n75 (97.4%) and 72 (93.5%) had already undergone associated MRI and endorectal ultrasonography (ERS) respectively.\nVC preparation and technique\nThe day before the examination,\nall patients received a light colonic preparation to ensure adequate intestinal cleansing.\nThe examination started with limited pressure carbon dioxide insufflation. Scans were performed on a 64-multidetector CT...\nResults\nPathological analysis confirmed the diagnosis of intestinal endometriosis in 73 (95%) cases.\nRectal,\nsigmoid,\ntransverse colon,\ncaecal and ileal involvements were observed in 70 (96%),\n32 (4%),\n2 (3%),\n5 (7%) and 6 (8%) cases respectively (Figures 6-19).\nOverall sensibility of VC for the diagnosis of intestinal involvement was 97.3% and was significantly higher compared to MRI (83.2%,\np=0.002),\nbut not significantly different from ERS (89.7%,\np=0.07).\nSensibilities for the diagnosis of rectal,\nsigmoid,\ntransverse colon,\ncaecal and ileal wall involvements using VC were 83%,...\nConclusion\nIn this prospective series,\nvirtual colonoscopy displayed at least similar sensitivity as ERS and MRI in the assessment of intestinal involvement and therfore yields high diagnostic performance in the pre-operative evaluation of patients with intestinal endometriosis.\nWhile MRI remains the gold standard in the evaluation of gynecological involvements,\nVC allows additionnal assessment of several intestinal locations,\nwhich are not accessible to ERS,\nbut also brings valuable information regarding the existence and type of rectal stenosis.\nIn that sense,\nVC clearly challenges ERS in the standard...\nReferences\n1.\nvan der Wat J,\nKaplan MD.\nModified virtual colonoscopy: a noninvasive technique for the diagnosis of rectovaginal septum and deep infiltrating pelvic endometriosis. J Minim Invasive Gynecol.\n2007 Sep-Oct;14(5):638-43.\n2.\nVassilieff M,\nSuaud O,\nCollet-Savoye C,\nDa Costa C,\nMarouteau-Pasquier N,\nBelhiba H,\nTuech JJ,\nMarpeau L,\nRoman H.\nComputed tomography-based virtual colonoscopy: an examination useful for the choice of the surgical management of colorectal endometriosis. Gynecol Obstet Fertil.\n2011 Jun;39:339-45.","source_license":"CC0","license_restricted":false}