Skip to main content

Advertisement

SpringerLink
Log in

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

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Woodward PJ, Sohaey R, Mezzetti TP. Endometriosis: radiologic-pathologic correlation. Radiographics 2001;21:193-216

    CAS  PubMed  Google Scholar 

  2. Olive DL, Schwartz LB. Endometriosis N Engl J Med 1993;328:1759-1779

    Article  CAS  PubMed  Google Scholar 

  3. Lu PY, Ory SJ. Endometriosis: current management Mayo Clin Proc 1993;70:453-463

    Article  Google Scholar 

  4. Cornillie FJ, Oosterlynck D, Lauweryns JM, et al. Deeply infiltrating pelvic endometriosis: histology and clinical significance Fertil Steril 1990;53:978- 983

    CAS  PubMed  Google Scholar 

  5. Jubanyik KJ, Comite F. Extra-pelvic endometriosis Obstet Gynecol Clin North Am 1997;24:411-440

    Article  CAS  PubMed  Google Scholar 

  6. Faccioli N, Manfredi R, Mainardi P, et al. Barium enema evaluation of colonic involvement in endometriosis AJR 2008;190:1050-1054

    Article  PubMed  Google Scholar 

  7. Rock JA. The revised American Fertility Society classification of endometriosis: reproducibility of scoring. ZOLADEX Endometriosis Study Group Fertil Steril 1995;63:1108-1110

    CAS  PubMed  Google Scholar 

  8. Prystowsky JB, Stryker SJ, Ujiki GT, et al. Gastrointestinal endometriosis: incidence and indications for resection Arch Surg 1988;123:855-858

    CAS  PubMed  Google Scholar 

  9. Landi S, Barbieri F, Fiaccavento A, et al.Preoperative double-contrast barium enema in Patients with suspected intestinal endometriosis. J Am Assoc Gynecol Laparosc 2004;11:223-228

    Article  PubMed  Google Scholar 

  10. La Seta F, Buccellato A, Tese L, et al. Multidetector-row CT enteroclysis: indications and clinical applications Radiol Med 2006;111:141-158

    Article  CAS  PubMed  Google Scholar 

  11. Biscaldi E, Ferrero S, Fulcheri E, et al. Multislice CT enteroclysis in the diagnosis of bowel endometriosis. Eur Radiol 2007;17:211-219

    Article  PubMed  Google Scholar 

  12. Biscaldi E, Ferrero S, Remorgida V, et al. Bowel endometriosis: CT-enteroclysis. Abdom Imaging 2007;32:441-450

    Article  PubMed  Google Scholar 

  13. Zanardi R, Del Frate C, Zuiani C, et al. Staging of pelvic endometriosis using magnetic resonance imaging compared with the laparoscopic classification of the American Fertility Society: a prospective study. Radiol Med 2003;105:326-338

    PubMed  Google Scholar 

  14. Del Frate C, Girometti R, Pittino M, et al. Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. Radiographics 2006;26:1705-1718

    Article  PubMed  Google Scholar 

  15. Chapron C, Vieira M, Chopin N, et al. Accuracy of rectal endoscopic ultrasonography and magnetic resonance imaging in the diagnosis of rectal involvement for patients presenting with deeply infiltrating endometriosis. Ultrasound Obstet Gynecol 2004;24:175-179

    Article  CAS  PubMed  Google Scholar 

  16. Remorgida V, Ferrero S, Fulcheri E, et al. Bowel Endometriosis: Presentation, Diagnosis, and Treatment. Obstet Gynecol Surv 2007;62:461-470

    Article  PubMed  Google Scholar 

  17. Gedgaudas RK, Kelvin FM, Thompson WM, et al. The value of the preoperative barium-enema examination in the assessment of pelvic masses. Radiology 1983;146:609-613

    CAS  PubMed  Google Scholar 

  18. Gordon RL, Evers K, Kressel HY. Double-contrast enema in pelvic endometriosis. AJR 1982;138:549-552

    CAS  PubMed  Google Scholar 

  19. Rollandi GA, Biscaldi E, DeCicco E et al. Double contrast barium enema: technique, indications, results and limitations of a conventional imaging methodology in the MDCT virtual endoscopy era. Eur J Radiol 2007;61:382-387

    Article  PubMed  Google Scholar 

  20. Kinkel K, Frei KA, Balleyguier C, et al. Diagnosis of endometriosis with imaging: a review. Eur Radiol 2006;16:285-298

    Article  PubMed  Google Scholar 

  21. Bazot M, Darai E, Hourani R, et al. Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 2004;232:379-389

    Article  PubMed  Google Scholar 

  22. NJ Parr, C Murphy, S Holt, et al. Endometriosis and the gut. Gut 1988; 29:1112-1115

    Article  CAS  PubMed  Google Scholar 

  23. Rowland R, Langman JM. Endometriosis of the large bowel: a report of 11 cases. Pathology 1989;21:259-265

    Article  CAS  PubMed  Google Scholar 

  24. Koninckx PR, Meuleman C, Demeyere S, et al. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril 1991;55:759-765

    CAS  PubMed  Google Scholar 

  25. Coronado C, Franklin RR, Lotze EC, et al. Surgical treatment of symptomatic colorectal endometriosis. Fertil Steril 1990;53:411-416

    CAS  PubMed  Google Scholar 

  26. Chapron C, Dumontier I, Dousset B, et al. Results and role of rectal endoscopic ultrasonography for patients with deep pelvic endometriosis. Hum Reprod 1998;13:2266-2270

    Article  CAS  PubMed  Google Scholar 

  27. Scarmato VJ, Levine MS, Herlinger H, et al. Ileal endometriosis: radiographic findings in five cases. Radiology 2000;214:509-551

    CAS  PubMed  Google Scholar 

  28. Roseau G, Dumontier I, Palazzo L, et al. Rectosigmoid endometriosis: Endoscopic ultrasound features and clinical implications. Endoscopy 2000;32:525–530

    Article  CAS  PubMed  Google Scholar 

  29. Koga K, Osuga Y, Yano T, et al. Characteristic images of deeply infiltrating rectosigmoid endometriosis on transvaginal and transrectal ultrasonography. Hum Reprod 2002;18:1328-1333.

    Article  Google Scholar 

  30. Glastonbury CM. The shading sign. Radiology 2002; 224:199-201

    Article  PubMed  Google Scholar 

  31. Rodriguez Gomez S, Pagés Llinas M, Castells Garangou A, et al. Dark-lumen MR colonography with fecal tagging: a comparison of water enema and air methods of colonic distention for detecting colonic neoplasms. Eur Radiol 2008;18:1396-1405

    Article  PubMed  Google Scholar 

  32. Ajaj W, Lauenstein TC, Pelster G, et al. MR colonography: how does air compare to water for colonic distention? J Magn Reson Imaging 2004;19:216-221

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

We thank Yves Doessant for assistance in preparing the manuscript.

Author information

Authors and Affiliations

  1. Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy

    N. Faccioli, G. Foti, R. Manfredi & R. Pozzi Mucelli

  2. Department of Radiology, Sacro Cuore Hospital, Negrar, Verona, Italy

    P. Mainardi & E. Spoto

  3. Department of Gynecology, Sacro Cuore Hospital, Negrar, Verona, Italy

    G. Ruffo & L. Minelli

Authors
  1. N. Faccioli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Foti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Manfredi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Mainardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E. Spoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Ruffo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L. Minelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. R. Pozzi Mucelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. Faccioli.

Rights and permissions

Reprints 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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-009-9544-5

Keywords

Search

Navigation