计算机断层结肠成像与直肠水造影经阴道超声检查在直肠乙状结肠子宫内膜异位症诊断中的应用：一项初步研究

Computed tomographic colonography vs rectal water- contrast transvaginal sonography in diagnosis of rectosigmoid endometriosis: a pilot study.

作者信息

Ferrero S, Biscaldi E, Vellone V G, Venturini P L, Leone Roberti Maggiore U

机构信息

Academic Unit of Obstetrics and Gynaecology, IRCCS AOU San Martino - IST, Genoa, Italy.

Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.

出版信息

Ultrasound Obstet Gynecol. 2017 Apr;49(4):515-523. doi: 10.1002/uog.15905.

DOI:10.1002/uog.15905

PMID:26935873

Abstract

OBJECTIVES

To compare the performance of computed tomographic colonography (CTC) and rectal water-contrast transvaginal sonography (RWC-TVS) in the diagnosis of rectosigmoid endometriosis, and compare precision in estimating the length of the rectosigmoid nodules and the distance between the nodules and the anal verge.

METHODS

This prospective study included 70 patients of reproductive age with clinical suspicion of rectosigmoid endometriosis. Patients underwent RWC-TVS and CTC before laparoscopic excision of endometriotic nodules. The findings of RWC-TVS and CTC were compared with surgical and histological results.

RESULTS

Of the 70 patients included in the study, 40 (57.1%) had rectosigmoid endometriosis. CTC and RWC-TVS had similar accuracy in the diagnosis of rectosigmoid endometriosis (P = 0.508) and similar precision in estimating the length of the endometriotic nodules (P = 0.077). CTC was more precise than RWC-TVS in estimating the distance between the rectosigmoid nodule and the anal verge (P < 0.001). The intensity of pain experienced during CTC was higher than that perceived during RWC-TVS (P < 0.001); however, intestinal distension for CTC was well-tolerated in all patients without significant adverse effects.

CONCLUSIONS

RWC-TVS and CTC have similar accuracy in the diagnosis of rectosigmoid endometriosis and similar precision in estimating the size of the nodules; however, CTC is more precise than RWC-TVS in estimating the distance between the nodules and the anal verge, yet patients tolerate RWC-TVS better than CTC. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

摘要

目的

比较计算机断层结肠成像（CTC）和直肠水造影经阴道超声检查（RWC-TVS）在诊断直肠乙状结肠子宫内膜异位症中的表现，并比较二者在估计直肠乙状结肠结节长度以及结节与肛缘距离方面的准确性。

方法

本前瞻性研究纳入了70例临床怀疑患有直肠乙状结肠子宫内膜异位症的育龄患者。在腹腔镜切除子宫内膜异位结节之前，患者接受了RWC-TVS和CTC检查。将RWC-TVS和CTC的检查结果与手术及组织学结果进行比较。

结果

在纳入研究的70例患者中，40例（57.1%）患有直肠乙状结肠子宫内膜异位症。CTC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（P = 0.508），在估计子宫内膜异位结节长度方面具有相似的准确性（P = 0.077）。在估计直肠乙状结肠结节与肛缘的距离方面，CTC比RWC-TVS更准确（P < 0.001）。CTC检查期间患者经历的疼痛强度高于RWC-TVS期间的疼痛强度（P < 0.001）；然而，所有患者对CTC引起的肠道扩张耐受性良好，无明显不良反应。