Magnetic Resonance Colonography May Predict the Need for Bowel Resection in Colorectal Endometriosis. (25th September 2017)

• Record Type: Journal Article
• Authors: Scardapane, Arnaldo; Lorusso, Filomenamila; Francavilla, Mariantonietta; Bettocchi, Stefano; Fascilla, Fabiana Divina; Angelelli, Giuseppe; Scioscia, Marco
• Other Names: Minutoli Fabio Academic Editor.
• Is Part Of: BioMed research international. Volume 2017(2017)
• Publication Date: 2017-09-25
• Subjects: Medicine -- Periodicals; Biology -- Periodicals; Biotechnology -- Periodicals; Life sciences -- Periodicals; 610.5
• DOI: 10.1155/2017/5981217
• Languages: English
• ISSNs: 2314-6133

Abstract

Abstract : Purpose . To define if MRI findings in patients with deep pelvic endometriosis (DPE) may be predictive for the need of bowel resection. Material and Methods . A retrospective survey of 196 pelvic MRIs of women who received laparoscopic procedures for DPE was carried out. A pelvic MRI was performed in all patients: it consisted in T2w-TSE sequences in axial, sagittal, and coronal planes and T1w and THRIVE sequences in the axial plane; the exam was completed by MR-Colonography. Intestinal lesions were measured in short and long axis and the degree of stenosis was established. A multivariate logistic regression was used to identify the predictors of intestinal resection. Results . 57/196 patients received an intestinal resection. Multivariate logistic regression demonstrated a predictive value of short axis (Odds-Ratio = 2.29, p = 0.011 ) and stenosis (Odds-Ratio = 1.20, p = 0.003 ). ROC analysis showed that a cut-off value of 11 mm for the short axis and 30% for the stenosis may correctly classify, respectively, 96, 94% (sensitivity 92, 9% and specificity 98, 56%) and 97, 96% (sensitivity 94, 74% and specificity 99, 3%) of the cases. Conclusion . The presence of an endometriotic rectal nodule > 11 mm in short axis causing a stenosis > 30% in pelvic MRI reliably predicts the need of a rectal resection.