Niccolo' Faccioli MD, Abstract Co-Author: Nothing to Disclose

Riccardo Manfredi MD, Presenter: Nothing to Disclose

Paride Mainardi MD, Abstract Co-Author: Nothing to Disclose

Mauro Ferrari, Abstract Co-Author: Nothing to Disclose

Luca Minelli MD, Abstract Co-Author: Nothing to Disclose

Roberto Pozzi Mucelli, Abstract Co-Author: Nothing to Disclose

To assess intestinal involvement by means of Double-Contrast Barium Enema (DCBE) and Magnetic Resonance (MR) imaging in young patients affected by endometriosis, in correlation with surgical findings.

Forty patients with clinical diagnosis of severe pelvic endometriosis were examined by DCBE and MR without contrast medium. We evaluated presence of the lesions, site (rectum, recto-sigmoid junction, sigmoid, cecum), morphology (cystic-nodular, plaque-like, complex) and extension of the colonic wall involvement. DCBE and MR were blindly evaluated. The lesions were resected at surgery and analysed at pathology.

DCBE showed 39 foci of intestinal endometriosis in 29 Patients, 15 in the rectum, 12 in the recto-sigmoid junction, 8 in the sigmoid and 4 in the cecum. MR imaging showed 27 foci of intestinal endometriosis in 21 Patients, 12 in the rectum, 10 in the recto-sigmoid junction, 3 in the sigmoid and 2 in the cecum. At DCBE 20/39 foci appeared cystic-nodular, 14/39 plaque-like and 5/39 complex. At MR imaging 13/27 foci appeared as cystic-nodular, 9/27 as plaque-like and 5/27 as complex. The mean colonic wall involvement at DCBE was 2.6 cm, at MR 1.9 cm. At pathology there were 48 lesions in 35 Patients, 18 lesions in the rectum, 15 in the recto-sigmoid junction, 9 in the sigmoid and 5 in the cecum; 24/48 appeared as cystic-nodular, 16/48 as plaque-like and 8/48 as complex. The mean colonic wall involvement at pathology was 3.0 cm. Sensibility of DCBE was 81%, specificity 83%, accuracy 81%, positive and negative predictive value were 97% and 35%. Sensibility of MR was 70%, specificity 83%, accuracy 71%, positive and negative predictive value were 96% and 29%.

DCBE showed a higher accuracy than MR in the detection of intestinal foci in a population affected by endometriosis.

Double contrast barium enema is better than MR in detecting intestinal foci of endometriosis and is recommended as preoperative examination.

Faccioli, N, Manfredi, R, Mainardi, P, Ferrari, M, Minelli, L, Pozzi Mucelli, R, Intestinal Endometriosis: Value of Double Contrast Barium Enema and Magnetic Resonance Imaging.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4437645.html