Multidetector Computerized Tomography Enema

In: Clinical Management of Bowel Endometriosis · 2020 · pp. 79–95 · doi:10.1007/978-3-030-50446-5_8 · W3083750763
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Multidetector computerized tomography enema accurately diagnoses bowel endometriosis by assessing lesion characteristics, outperforming other imaging techniques despite radiation exposure and contrast limitations.

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This paper describes multidetector computerized tomography enema (MDCT-e) as a diagnostic technique for bowel endometriosis, detailing its method of retrograde saline distention of the colon/cecum/last ileal loops, and the required bowel cleansing, intestinal hypotonization, and iodinated contrast administration. It reports that multiple studies found MDCT-e to have good diagnostic performance for detecting intestinal endometriotic nodules and for characterizing lesion features such as maximal diameter and distance from the anal verge, with performance generally comparable to or better than other commonly used imaging modalities. The paper’s explicit limitations are radiation exposure and the use of iodinated contrast medium in young women with a benign condition. This paper is centrally about endometriosis — it focuses on the diagnostic role, performance, and limitations of MDCT-e for rectosigmoid and other bowel endometriosis.

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Abstract

Over 10 years ago, multidetector computerized tomography enema (MDCT-e) was proposed for the diagnosis of bowel endometriosis. This technique is based on the retrograde distention of the colon, cecum, and last ileal loops with saline solution. The exam requires bowel cleansing, intestinal hypotonization, and the administration of iodinated contrast medium. Several studies demonstrated that MDCT-e has good performance not only in diagnosing the presence of intestinal endometriotic nodules but also in assessing the characteristics of the lesions (such as their largest diameter and distance from the anal verge). MDCT-e has good diagnostic performance when compared with other techniques commonly used for the diagnosis of bowel endometriosis such as transvaginal ultrasonography, rectal water contrast transvaginal ultrasonography, and magnetic resonance imaging. MDCT-e is usually well tolerated by the patients. However, this technique has two major limitations: the exposure to radiation and the administration of iodinated constraint medium to young women of reproductive age suffering a benign condition. In conclusion, MDCT-e has high diagnostic performance for rectosigmoid and other bowel endometriosis. It allows to reliably rule out the diagnosis with a negative result and to rule in the diagnosis with a positive result. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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Springer, Cham. https://doi.org/10.1007/978-3-030-50446-5_8 Download citation DOI: https://doi.org/10.1007/978-3-030-50446-5_8 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-50445-8 Online ISBN: 978-3-030-50446-5 eBook Packages: MedicineMedicine (R0)

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