Department of Obstetrics and Gynecology, San Martino Hospital and University of Genoa, Genoa, Italy.
Ultrasound Obstet Gynecol. 2011 May;37(5):603-13. doi: 10.1002/uog.8971. Epub 2011 Apr 5.
To compare the accuracy of multidetector computerized tomography enteroclysis (MDCT-e) and rectal water contrast transvaginal ultrasonography (RWC-TVS) in determining the presence and extent of bowel endometriosis.
This prospective study included 96 patients of reproductive age with suspicion of bowel endometriosis. Patients underwent MDCT-e and RWC-TVS before operative laparoscopy. Findings of MDCT-e and RWC-TVS were compared with histological results. The severity of pain experienced during MDCT-e and RWC-TVS was measured by a 10-cm visual analog scale.
Fifty-one patients had bowel endometriotic nodules at surgery. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the diagnosis of rectosigmoid endometriosis were 95.8% (46/48), 100.0% (48/48), 100.0% (46/46), 96.0% (48/50) and 97.9% (94/96) for MDCT-e and 93.8% (45/48), 97.9% (47/48), 97.8% (45/46), 94.0% (47/50) and 95.8% (92/96) for RWC-TVS. MDCT-e was associated with more intense pain than was RWC-TVS.
MDCT-e and RWC-TVS have similar accuracy in the diagnosis of rectosigmoid endometriosis, but patients tolerate RWC-TVS better than they do MDCT-e.
比较多层螺旋计算机肠造影（MDCT-e）和经直肠水对比经阴道超声（RWC-TVS）在确定肠子宫内膜异位症存在和程度方面的准确性。
本前瞻性研究纳入了 96 例怀疑患有肠子宫内膜异位症的育龄期患者。患者在手术腹腔镜检查前接受 MDCT-e 和 RWC-TVS 检查。将 MDCT-e 和 RWC-TVS 的检查结果与组织学结果进行比较。通过 10 厘米视觉模拟量表测量 MDCT-e 和 RWC-TVS 期间的疼痛严重程度。
51 例患者在手术中发现直肠乙状结肠子宫内膜异位症结节。直肠乙状结肠子宫内膜异位症的诊断的 MDCT-e 的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 95.8%（46/48）、100.0%（48/48）、100.0%（46/46）、96.0%（48/50）和 97.9%（94/96），RWC-TVS 分别为 93.8%（45/48）、97.9%（47/48）、97.8%（45/46）、94.0%（47/50）和 95.8%（92/96）。MDCT-e 比 RWC-TVS 引起更剧烈的疼痛。
MDCT-e 和 RWC-TVS 在诊断直肠乙状结肠子宫内膜异位症方面具有相似的准确性，但患者对 RWC-TVS 的耐受性优于 MDCT-e。
