The Role of Computed Tomography Colonography in Detecting Bowel Involvement in Women With Deep Infiltrating Endometriosis: Comparison With Clinical History, Serum Ca125, and Transvaginal Sonography

J Comput Assist Tomogr. 2016 Nov/Dec;40(6):886-891. doi: 10.1097/RCT.0000000000000447.

Abstract

Objective: We wanted to assess the diagnostic value of computed tomographic colonography (CTC) in recognizing bowel endometriosis in comparison with serum Ca125, transvaginal sonography (TVS), and presence of intestinal symptoms.

Methods: We included in this study 92 women undergoing surgery for symptomatic DIE. Preoperative evaluation included clinical history, Ca125 serum value, and TVS. CTC was performed in 37/92 patients (40.2%), and the results were compared to the other preoperative tools and to surgical exploration, considered the clinical reference standard.

Results: Surgery confirmed bowel endometriosis in 49/92 subjects (53.3%). Presence of intestinal symptoms, serum Ca125 values, and TVS were significantly correlated to intestinal involvement, but CTC had the highest accuracy in detecting bowel endometriosis with a sensitivity of 68%, a specificity of 67%, a PPV of 81%, and a NPV of 50% (P = 0.04).

Conclusions: CTC proved to be an accurate and low invasive imaging technique to detect DIE of the bowel and compared favorably with clinical evaluation, serum Ca125 determination, and TVS.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Biomarkers, Tumor / blood
  • CA-125 Antigen / blood*
  • Colonography, Computed Tomographic / statistics & numerical data*
  • Endometriosis / blood
  • Endometriosis / diagnosis*
  • Endometriosis / epidemiology*
  • Female
  • Humans
  • Intestinal Diseases / blood
  • Intestinal Diseases / diagnosis*
  • Intestinal Diseases / epidemiology*
  • Italy / epidemiology
  • Medical History Taking / statistics & numerical data
  • Membrane Proteins / blood*
  • Middle Aged
  • Prevalence
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity
  • Ultrasonography / statistics & numerical data

Substances

  • Biomarkers, Tumor
  • CA-125 Antigen
  • MUC16 protein, human
  • Membrane Proteins