Uro colon CT in the diagnosis of pelvic deep infiltrating endometriosis

Sara Zanardi
2017 · vol. 8 , pp. 421 · doi:10.1594/ecr2017/b-1099 · W2604689950
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This poster presents uro colon CT as a diagnostic tool for pelvic deep infiltrating endometriosis, authored by researchers from Bologna, Italy.

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This retrospective study evaluated the diagnostic accuracy of uro-colon CT in 186 patients with a strong clinical suspicion of pelvic deep infiltrating endometriosis involving the intestinal or urinary tracts. The findings indicated that the technique successfully identified gastrointestinal lesions in 75.3% of cases and urinary tract involvement in 63.0%, often necessitating surgical consultation from general surgeons or urologists. The authors note that while radiation exposure remains a limitation for young females, the protocol utilizes dose reduction strategies to mitigate this risk. This paper is centrally about endometriosis — specifically the preoperative imaging evaluation of deep infiltrating nodules affecting the bowel and bladder.

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Abstract

Poster: ECR 2017 / B-1099 / Uro colon CT in the diagnosis of pelvic deep infiltrating endometriosis by: S. Zanardi, F. Coppola, D. Papadopoulos, D. Valerio, A. O. Di Vincenzo, L. Zannoni, R. Seracchioli, R. Golfieri; Bologna/IT
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Keywords

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.

Methods

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...

Results

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...

Conclusion

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...

References

1.Chapron C,Fauconnier A, Dubuisson JB, Barakat H, Vieira M, Breart G. Deep infiltrating endometriosis: relation between severity of dysmenorrhoea and extent of disease. Human Reproduction 2003; 18(4):760-766. 2. Roman H, Ness I, Suciu N, Bridoux V, Gourcerol G, Leroi AM et Al. Are digestive symptoms in women presenting with pelvic endometriosis specific to lesion localizations? A preliminary prospective study. Hum Reprod 2012; 27(12):3440-3449. 3. Moawad NS, Caplin A. Diagnosis, management, and long-term outcomes of rectovaginal endometriosis. Int J Womens Health 2013; 5:753-63 4. Ferrero S,...

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Condition tags

endometriosisdie_deep_infiltrating

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