The comparison between MRI and MSCT-enteroclysis in the diagnosis of bowel endometriosis

Purpose: To compare the effectiveness of MRI and MSCT-enteroclysis (MSCTe) in determining the presence of bowel endometriosis (BEM) and the depth of bowel wall infiltration of the nodules. Material and methods: We evaluated 26 women (aged 19–38) with signs and symptoms suggestive of colorectal endometriosis. Patients underwent MRI (1T magnet, phased array coil, multiplanar FSET1, T1 fat sat, T2, T1 post-Gado sequences) and MSCTe (16 rows). The exams were reviewed independently by two radiologists. All women underwent laparoscopy within 2 weeks; radiological findings were compared with surgical and histological data. Statistical analysis was performed with SPSS 13.0. Results: The presence of BEM was detected by MRI in 11 (42.3%) women and by MSCTe in 12 (46.2%). Surgery confirmed BEM in 12 patients identified by MSCTe. In the diagnosis, sensibility, specificity, PPV, NPV were 91.7, 100, 100, 93.3% for MRI and 100, 100, 97, 100% for MSCTe. 21 nodules were identified by MRI and 22 by MSCTe; surgery identified 25 nodules: 13 located on the rectum, 11 at sigmoid colon, and 1 at caecum. One false positive nodule was observed at MSCTe. Among correctly identified nodules, MRI estimated the depth of infiltration to the serosa in 8 cases and to the muscularis in 13. At MSCTe, 4 nodules were judged to infiltrate the serosa, 16 to reach the muscularis propria, and 1 the mucosa. MSCTe correctly estimated the depth of nodules infiltration, significantly more frequently than MRI (p=0.048; Fisher‘s exact test). Conclusion: Both MRI and MSCTe reliably detect the BEM nodules; however, MSCTe is more accurate in estimating the depth of infiltration in the bowel wall.