Multidetector Computerized Tomography Enema

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.