Rectal water contrast transvaginal ultrasound versus double-contrast barium enema in the diagnosis of bowel endometriosis

BMJ Open. 2017 Sep 7;7(9):e017216. doi: 10.1136/bmjopen-2017-017216.

Abstract

Objectives: The aim of study was to compare the accuracy between rectal water contrast transvaginal ultrasound (RWC-TVS) and double-contrast barium enema (DCBE) in evaluating the bowel endometriosis presence as well as its extent.

Design and setting: 198 patients at reproductive age with suspicious bowel endometriosis were included. Physicians in two groups specialised at endometriosis performed RWC-TVS as well as DCBE before laparoscopy and both groups were blinded to other groups' results. Findings from RWC-TVS or DCBE were compared with histological results. The severity of experienced pain severity through RWC-TVS or DCBE was assessed by an analogue scale of 10 cm.

Results: In total, 110 in 198 women were confirmed to have endometriosis nodules in the bowel by laparoscopy as well as histopathology. For bowel endometriosis diagnosis, DCBE and RWC-TVS demonstrated sensitivities of 96.4% and 88.2%, specificities of 100% and 97.3%, positive prediction values of 100% and 98.0%, negative prediction values of 98.0% and 88.0%, accuracies of 98.0% and 92.4%, respectively. DCBE was related to more tolerance than RWC-TVS.

Conclusions: RWC-TVS and DCBE demonstrated similar accuracies in the bowel endometriosis diagnosis; however, patients showed more tolerance for RWC-TVS than those with DCBE.

Keywords: bowel endometriosis; diagnosis; double-contrast barium enema; rectal water contrast transvaginal ultrasound.

MeSH terms

  • Adult
  • Barium Enema
  • China
  • Colonic Diseases / diagnostic imaging*
  • Contrast Media*
  • Endometriosis / diagnostic imaging*
  • Female
  • Humans
  • Laparoscopy
  • Prospective Studies
  • Rectum
  • Sensitivity and Specificity
  • Ultrasonography
  • Vagina
  • Water*

Substances

  • Contrast Media
  • Water