Evaluation of colonic involvement in endometriosis: double-contrast barium enema vs. magnetic resonance imaging

Niccolò Faccioli, N Faccioli, Giovanni Foti, G Foti, Manfredi R, R Manfredi, Riccardo Manfredi, Paride Mainardi, Mainardi P, P Mainardi, Elide Spoto, E Spoto, Spoto E, G Ruffo, Giacomo Ruffo, Ruffo G, Minelli L, L Minelli, Liliana Minelli, R Pozzi Mucelli, Roberto Pozzi Mucelli, Mucelli RP
Abdominal imaging · 2009 · vol. 35(4) , pp. 414–421 · doi:10.1007/s00261-009-9544-5 · PMID:19568808 · W1967124455
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-12 ⓘ

This study found double-contrast barium enema (DCBE) more accurate than unenhanced MRI for diagnosing bowel endometriosis, recommending DCBE for preoperative planning.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This prospective study compared the diagnostic accuracy of double-contrast barium enema (DCBE) versus magnetic resonance imaging (MRI) for intestinal endometriosis in 83 consecutive women with suspected bowel involvement, with DCBE and MRI performed the same day and findings correlated to histology from resected surgical specimens. Of 65 operated patients, 50 (76.9%) had bowel endometriosis, and DCBE detected 50/59 lesions (84.7%) versus MRI detecting 42/59 (71.1%); DCBE also showed higher overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy than MRI. The main limitation is that accuracy is assessed against resected specimens, and only 65 of the 83 women underwent surgery (with diagnostic comparison focused on that subset). This paper is centrally about endometriosis — it directly evaluates imaging accuracy (DCBE vs MRI) for colonic involvement in intestinal endometriosis using histology as the reference standard.

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Abstract

BackgroundThe purpose of the study was to compare the accuracy of double-contrast barium enema (DCBE) and magnetic resonance imaging (MRI) in the diagnosis of intestinal endometriosis using the histological examination on resected specimen as comparative standard.MethodsEighty-three consecutive patients with suspected intestinal endometriosis, resected between 2005 and 2007, were prospectively evaluated. All of the women underwent preoperative DCBE and MRI on the same day. We evaluated number, site (rectum, sigmoid, cecum), and size of the lesions. The imaging findings were correlated with those resulting at pathology.ResultsAmong the 65 women who underwent surgery, 50/65 (76.9%) were found to have bowel endometriosis, with 9/50 (18%) patients presenting two lesions; DCBE allowed to detect 50/59 (84.7%) lesions. MRI allowed to detect 42/59 (71.1%) lesions. DCBE showed sensibility, specificity, PPV, NPV, and accuracy of respectively 84.7, 93.7, 98.0, 62.5, and 86.6%, MRI of 71.1, 83.3, 93.3, 46.8, and 74.6%.ConclusionDCBE is more accurate than unenhanced MRI in the diagnosis of bowel endometriosis, and should be preferred in the preoperative management of this disease, since it usually enables a proper surgical planning.
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Abstract

Background The purpose of the study was to compare the accuracy of double-contrast barium enema (DCBE) and magnetic resonance imaging (MRI) in the diagnosis of intestinal endometriosis using the histological examination on resected specimen as comparative standard.

Methods

Eighty-three consecutive patients with suspected intestinal endometriosis, resected between 2005 and 2007, were prospectively evaluated. All of the women underwent preoperative DCBE and MRI on the same day. We evaluated number, site (rectum, sigmoid, cecum), and size of the lesions. The imaging findings were correlated with those resulting at pathology.

Results

Among the 65 women who underwent surgery, 50/65 (76.9%) were found to have bowel endometriosis, with 9/50 (18%) patients presenting two lesions; DCBE allowed to detect 50/59 (84.7%) lesions. MRI allowed to detect 42/59 (71.1%) lesions. DCBE showed sensibility, specificity, PPV, NPV, and accuracy of respectively 84.7, 93.7, 98.0, 62.5, and 86.6%, MRI of 71.1, 83.3, 93.3, 46.8, and 74.6%.

Conclusion

DCBE is more accurate than unenhanced MRI in the diagnosis of bowel endometriosis, and should be preferred in the preoperative management of this disease, since it usually enables a proper surgical planning. Similar content being viewed by others

References

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J Magn Reson Imaging 2004;19:216-221 Acknowledgment We thank Yves Doessant for assistance in preparing the manuscript. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Faccioli, N., Foti, G., Manfredi, R. et al. Evaluation of colonic involvement in endometriosis: double-contrast barium enema vs. magnetic resonance imaging. Abdom Imaging 35, 414–421 (2010). https://doi.org/10.1007/s00261-009-9544-5 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00261-009-9544-5

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Condition tags

endometriosis

MeSH descriptors

Barium Sulfate Colonic Diseases Contrast Media Endometriosis Magnetic Resonance Imaging Tomography, X-Ray Computed Adult Colonic Diseases Colonic Diseases Colonic Diseases Endometriosis Endometriosis Endometriosis Enema Female Humans Predictive Value of Tests Rectal Diseases Rectal Diseases Rectal Diseases

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