Abstract
Over 10 years ago, multidetector computerized tomography enema (MDCT-e) was proposed for the diagnosis of bowel endometriosis. This technique is based on the retrograde distention of the colon, cecum, and last ileal loops with saline solution. The exam requires bowel cleansing, intestinal hypotonization, and the administration of iodinated contrast medium. Several studies demonstrated that MDCT-e has good performance not only in diagnosing the presence of intestinal endometriotic nodules but also in assessing the characteristics of the lesions (such as their largest diameter and distance from the anal verge). MDCT-e has good diagnostic performance when compared with other techniques commonly used for the diagnosis of bowel endometriosis such as transvaginal ultrasonography, rectal water contrast transvaginal ultrasonography, and magnetic resonance imaging. MDCT-e is usually well tolerated by the patients. However, this technique has two major limitations: the exposure to radiation and the administration of iodinated constraint medium to young women of reproductive age suffering a benign condition. In conclusion, MDCT-e has high diagnostic performance for rectosigmoid and other bowel endometriosis. It allows to reliably rule out the diagnosis with a negative result and to rule in the diagnosis with a positive result.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Pilleul F, Bansac-Lamblin A, Monneuse O, Dumortier J, Milot L, Valette PJ. Water enema computed tomography: diagnostic tool in suspicion of colorectal tumor. Gastroenterol Clin Biol. 2006;30(2):231–4.
Ridereau-Zins C, Aube C, Luet D, Vielle B, Pilleul F, Dumortier J, et al. Assessment of water enema computed tomography: an effective imaging technique for the diagnosis of colon cancer: colon cancer: computed tomography using a water enema. Abdom Imaging. 2010;35(4):407–13.
Soyer P, Sirol M, Dray X, Place V, Pautrat K, Hamzi L, et al. Detection of colorectal tumors with water enema-multidetector row computed tomography. Abdom Imaging. 2012;37(6):1092–100.
Soyer P, Hamzi L, Sirol M, Duchat F, Dray X, Hristova L, et al. Colon cancer: comprehensive evaluation with 64-section CT colonography using water enema as intraluminal contrast agent-a pictorial review. Clin Imaging. 2012;36(2):113–25.
Iosca S, Lumia D, Bracchi E, Duka E, De Bon M, Lekaj M, et al. Multislice computed tomography with colon water distension (MSCT-c) in the study of intestinal and ureteral endometriosis. Clin Imaging. 2013;37(6):1061–8.
Biscaldi E, Ferrero S, Leone Roberti Maggiore U, Remorgida V, Venturini PL, Rollandi GA. Multidetector computerized tomography enema versus magnetic resonance enema in the diagnosis of rectosigmoid endometriosis. Eur J Radiol. 2014;83(2):261–7.
Ferrero S, Biscaldi E, Morotti M, Venturini PL, Remorgida V, Rollandi GA, et al. Multidetector computerized tomography enteroclysis vs. rectal water contrast transvaginal ultrasonography in determining the presence and extent of bowel endometriosis. Ultrasound Obstet Gynecol. 2011;37(5):603–13.
Biscaldi E, Ferrero S, Fulcheri E, Ragni N, Remorgida V, Rollandi GA. Multislice CT enteroclysis in the diagnosis of bowel endometriosis. Eur Radiol. 2007;17(1):211–9.
Biscaldi E, Ferrero S, Remorgida V, Rollandi GA. MDCT enteroclysis urography with split-bolus technique provides information on ureteral involvement in patients with suspected bowel endometriosis. AJR Am J Roentgenol. 2011;196(5):W635–40.
Biscaldi E, Ferrero S, Remorgida V, Rollandi GA. Bowel endometriosis: CT-enteroclysis. Abdom Imaging. 2007;32(4):441–50.
Telegrafo M, Lorusso V, Rubini G, Rella L, Pezzolla A, Stabile Ianora AA, et al. [Sigmoid endometriosis: a diagnostic dilemma on multidetector CT]. Recenti Prog Med. 2013;104(7–8):438–41.
Guadagno A, Grillo F, Vellone VG, Ferrero S, Fasoli A, Fiocca R, et al. Intestinal endometriosis: mimicker of inflammatory bowel disease? Digestion. 2015;92(1):14–21.
Valenzano Menada M, Remorgida V, Abbamonte LH, Nicoletti A, Ragni N, Ferrero S. Does transvaginal ultrasonography combined with water-contrast in the rectum aid in the diagnosis of rectovaginal endometriosis infiltrating the bowel? Hum Reprod. 2008;23(5):1069–75.
Menada MV, Remorgida V, Abbamonte LH, Fulcheri E, Ragni N, Ferrero S. Transvaginal ultrasonography combined with water-contrast in the rectum in the diagnosis of rectovaginal endometriosis infiltrating the bowel. Fertil Steril. 2008;89(3):699–700.
Morotti M, Ferrero S, Bogliolo S, Venturini PL, Remorgida V, Valenzano Menada M. Transvaginal ultrasonography with water-contrast in the rectum in the diagnosis of bowel endometriosis. Minerva Ginecol. 2010;62(3):179–85.
Ferrero S, Leone Roberti Maggiore U, Venturini PL, Rollandi GA, Biscaldi E. Multidetector computerized tomography enteroclysis versus magnetic resonance enteroclysis in the diagnosis of colorectal endometriosis. Fertil Steril. 2013;100(3 Suppl):S103.
Zouari-Zaoui L, Soyer P, Merlin A, Boudiaf M, Nemeth J, Rymer R. Multidetector row helical computed tomography enteroclysis findings in ileal endometriosis. Clin Imaging. 2008;32(5):396–9.
Boudiaf M, Jaff A, Soyer P, Bouhnik Y, Hamzi L, Rymer R. Small-bowel diseases: prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients. Radiology. 2004;233(2):338–44.
Nisenblat V, Bossuyt PM, Farquhar C, Johnson N, Hull ML. Imaging modalities for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016;(2):CD009591.
Ferrero S, Barra F, Stabilini C, Vellone VG, Leone Roberti Maggiore U, Scala C. Does bowel preparation improve the performance of rectal water contrast transvaginal ultrasonography in diagnosing rectosigmoid endometriosis? J Ultrasound Med. 2018;38(4):1017–25.
Ferrero S, Scala C, Stabilini C, Vellone VG, Barra F, Leone Roberti Maggiore U. Transvaginal ultrasonography with or without bowel preparation in the diagnosis of rectosigmoid endometriosis: prospective study. Ultrasound Obstet Gynecol. 2018;53(3):402–9.
Guerriero S, Condous G, Van den Bosch T, Valentin L, Leone FP, Van Schoubroeck D, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol. 2016;48:318.
Singh J, Daftary A. Iodinated contrast media and their adverse reactions. J Nucl Med Technol. 2008;36(2):69–74; quiz 6–7.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Biscaldi, E., Barra, F., Moawad, G., Leone Roberti Maggiore, U., Ferrero, S. (2020). Multidetector Computerized Tomography Enema. In: Ferrero, S., Ceccaroni, M. (eds) Clinical Management of Bowel Endometriosis. Springer, Cham. https://doi.org/10.1007/978-3-030-50446-5_8
Download citation
DOI: https://doi.org/10.1007/978-3-030-50446-5_8
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-50445-8
Online ISBN: 978-3-030-50446-5
eBook Packages: MedicineMedicine (R0)