The value of double-contrast enema in the assessment of ovarian carcinoma's diffusion

Abstract

Because of the spread of ovarian carcinoma, peritoneoscopy plus diaphragmatic inspection, peritoneal cytology, and lymphangiography are the essential procedures for staging, reassessment, and restaging of the disease. Another procedure that can be important is double-contrast enema (DCE). Eighty-one patients with ovarian carcinoma were evaluated with all four procedures. In the 21 new cases, DCE was positive in 9 (42.8%), but the conversion rate was equal to 0. In 6 out of 27 reassessment patients DCE gave information about the disease's spread and in one patient changed the stage. In 17 restaging patients with clinical evidence of disease, five had positive DCE. In 16 restaging patients without clinical evidence of disease, no patient had positive DCE. Twenty six patients were submitted to laparotomy: the radiologic accuracy in patients with positive DCE was 86%; the total radiologic accuracy was equal to 77%. From the present data it appears that the radiological examination, although having a low-stage conversion index, may give a high percentage of information about the abdominal spread of the ovarian carcinoma.