Department of Radiology, Galliera Hospital, via Mura delle Capuccine 14, 16128 Genoa, Italy.
Department of Obstetrics and Gynecology, San Martino Hospital and National Institute for Cancer Research, University of Genoa, Largo Rosanna Benzi, 1, 16132 Genoa, Italy.
Eur J Radiol. 2014 Feb;83(2):261-7. doi: 10.1016/j.ejrad.2013.10.010. Epub 2013 Nov 13.
To compare the accuracy of multidetector computerized tomography enema (MDCT-e) and magnetic resonance enema (MRI-e) in determining the presence of sigmoid and rectal endometriotic nodules.
260 women (32.6 ± 4.3 years) with symptoms suggestive of rectosigmoid endometriosis underwent MDCT-e and MRI-e prior to laparoscopy. After retrograde colonic distention and injection of intravenous contrast medium, patients were scanned on a 64-row MDCT scanner. MRI-e was performed on a 1.5T magnet using an 8 channels phased array coil; intestinal distention was achieved by introducing in the rectum 250-300 ml of ultrasonographic gel diluted with saline solution. Radiological findings were compared with surgical and histological results.
176 women had rectosigmoid endometriosis at surgery. There was no significant difference in the accuracy of MDCT-e (98.5%) and MRI-e (96.9%) in the diagnosis of sigmoid and rectal endometriosis (p=0.248). The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of MDCT-e and MRI-e were respectively 98.3%, 98.8%, 99.4%, 96.5%, 81.59, 0.02 and 97.2%, 96.4%, 98.3%, 94.1%, 26.89, 0.03.
Both MDCT-e and MRI-e are accurate in the diagnosis of rectal and sigmoid endometriosis.
比较多排螺旋 CT 肠造影（MDCT-e）和磁共振肠造影（MRI-e）在确定乙状结肠和直肠子宫内膜异位结节中的准确性。
260 名（32.6±4.3 岁）有直肠乙状结肠子宫内膜异位症症状的女性患者在腹腔镜检查前接受 MDCT-e 和 MRI-e 检查。静脉注射对比剂后逆行结肠扩张，对 64 排 MDCT 扫描仪进行扫描。在 1.5T 磁体上使用 8 通道相控阵线圈进行 MRI-e 检查；通过将 250-300ml 生理盐水稀释的超声凝胶注入直肠来实现肠道扩张。将影像学结果与手术和组织学结果进行比较。
176 名女性在手术中患有直肠乙状结肠子宫内膜异位症。MDCT-e（98.5%）和 MRI-e（96.9%）在诊断乙状结肠和直肠子宫内膜异位症方面的准确性无显著差异（p=0.248）。MDCT-e 和 MRI-e 的敏感性、特异性、阳性预测值、阴性预测值、阳性似然比和阴性似然比分别为 98.3%、98.8%、99.4%、96.5%、81.59、0.02 和 97.2%、96.4%、98.3%、94.1%、26.89、0.03。
MDCT-e 和 MRI-e 均能准确诊断直肠和乙状结肠子宫内膜异位症。
