Uro colon CT in the diagnosis of pelvic deep infiltrating endometriosis

Urinary Tract / Bladder, Colon, Genital / Reproductive system female, CT, Colonography CT, Dosimetric comparison Authors: S. Zanardi, F. Coppola, D. Papadopoulos, D. Valerio, A. O. Di Vincenzo, L. Zannoni, R. Seracchioli, R. Golfieri; Bologna/IT DOI: 10.1594/ecr2017/B-1099 Purpose To evaluate the diagnostic accuracy (DA) of CT-colonography with intravenous contrast medium and urographic phase (U-CTC) in the preoperative evaluation of pelvic deep infiltrating endometriosis (DIE) with intestinal and/or urinary tract localizations.

and materials We retrospectively analyzed the 186 consecutive patients that underwent an U-CTC examination for strong clinical suspicion of intestinal and/or urinary tract DIE. U-CTC is a low-dose CT colonography with a dedicated protocol with fasting for six hours before the examinations, then 10 minutes before the U-CTC an intramuscular injection of 20 mg of hyoscine-N-butylbromide was administered (in absence of contraindications) to reduce bowel peristalsis. The distention of the colon was obtained by introducing 1.5-2 L of air or CO2 in the rectum through a 24...

Fifty-five patients (75.3%) had lesions involving the GI tract at U-CTC (18 of them required the involvement of the general surgeon, 32.7%) while 46 patients (63.0%) had lesions involving the urinary tract and 31 of them (67.4%) required the involvement of an urologist. Thirty-six of these patients showed lesions in both compartments (49.3%). The diagnostic performance of U-CTC for the diagnosis of DIE according to the different anatomical localizations is shown in Table 1. As far as the intestinal lesions were concerned, U-CTC demonstrated sensitivity...

In our experience U-CTC is not routinely adopted for the diagnosis of endometriosis, usually achieved with TVS or MRI, but it is performed only before surgery, in selected patients with strong clinical suspicion of DIE nodules that result to be more difficult to detect with TVS and standard MRI, like localizations involving the sigmoid colon, the recto-sigmoid junction, the ureters and the bladder dome. The limitations of this technique is the radiation exposure in young females, even if a dose reduction protocol was utilized, but...

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