{"paper_id":"73f08cc9-fe7d-4c0d-976b-34d491806684","body_text":"ECR 2011 / C-0834\nContribution of CT virtual colonoscopy in the preoperative evaluation of deep colorectal endometriosis\nCongress:\nECR 2011\nPoster Number:\nC-0834\nType:\nScientific Exhibit\nKeywords:\nColonography CT, CT, Genital / Reproductive system female, Gastrointestinal tract, Colon\nAuthors:\nO. Suaud, C. Savoye-Collet, C. Da Costa, H. Belhiba, H. Roman, J.-N. Dacher; Rouen/FR\nDOI:\n10.1594/ecr2011/C-0834\nPurpose\nIntroduction\nEndometriosis is defined by the presence of functional endometrium outside the uterine cavity and myometrium.\nIts prevalence reaches up to 15% in child-bearing aged women.\nDeep lesions of endometriosis mainly grow on the posterior pelvic surface (pouch of Douglas,\nrectovaginal septum,\nutero-sacral ligaments,\nvesico-vaginal septum).\nGastrointestinal locations involve both rectum and sigmoid colon.\nSmall bowel and ureters may also be affected.\nThese injuries result in varied symptoms (gynecological,\ndigestive,\nurinary),\nmaking diagnosis difficult and delayed.\nDiagnostic imaging of deep endometriosis\nEndovaginal ultrasound (Fig1):\nUp...\nMethods and Materials\nEleven consecutive patients.\nAged 25 to 48 years (mean age = 32 years).\nDigestive disease with deep endometriosis diagnosed by ultrasound and MRI.\nPreoperative CT virtual colonoscopy was performed and results were compared to surgical findings .\nAcquisition protocol:\nDevelopment of an acquisition protocol suitable for young patients (low dose) and related to the disease (contrast enhancement of nodules).\nBowel preparation:\nLaxative solution and stool tagging according to the standard protocol for virtual colonoscopy (kit Prepacol®,\nMicropaque Scanner®,\nTelebrix Gastro®,\nGuerbet,\nFrance\nCT parameters:\n64...\nResults\nQuality of examination:\nGood in 91 % of cases\nNodules (Fig 5):\n13 nodules found in 11 patients (2 nodules for patients 5 and 11).\nVolume from 1.1 to 186 cm3.\nDigestive segments concerned (Fig 6):\nThe digestive disease was mainly spread to the recto sigmoid\nSmall bowel involvement was observed in one patient\nImpact on the luminal diameter (Fig 7):\n7 of 13 nodules resulted in significant stenosis of the digestive segment (reduction of the digestive lumen diameter compared to adjacent normal bowel loops)....\nConclusion\nNew surgical techniques in the management of deep endometriosis (which aim to be as minimally invasive as possible) raise new questions from clinicians.\nCTC in the preoperative evaluation of deep endometriosis is feasible and allows to specify the digestive involvement.\nThis contribution appears to provide satisfaction to gynecologists,\nguiding the surgical procedure.\nHowever,\na larger study is necessary to confirm our preliminary results.\nReferences\nDaraï E et al.\nCurr Opin Obstet Gynecol 2007;19:308-13 - Guerriero S,\nAjossa S,\nGerada M,et al. Hum Reprod 2008;23:2452-7.\n- Maubon A et al J Gynecol Obstet Biol Reprod 2007; 36: 129-34.Roman H et al. J Gynecol Obstet Biol Reprod 2007;36:141-50.","source_license":"CC0","license_restricted":false}