Hélène Gimonet1, Valérie Laigle-Quérat2, Stéphane Ploteau3, Cergika Veluppillai3, Brice Leclère4, Eric Frampas2. 1. Service de radiologie et imagerie médicale, Hôtel-Dieu, CHU de Nantes, 1 place Alexis-Ricordeau, 44093, Nantes, France. helene.gimonet@hotmail.fr. 2. Service de radiologie et imagerie médicale, Hôtel-Dieu, CHU de Nantes, 1 place Alexis-Ricordeau, 44093, Nantes, France. 3. Service de gynécologie-obstétrique, Hôpital Femme-enfant-adolescent, CHU de Nantes, 38 boulevard Jean-Monnet, 44093, Nantes, France. 4. Service d'évaluation médicale et d'épidémiologie, Hôpital St Jacques, CHU de Nantes, 85 rue St Jacques, 44093, Nantes, France.
Abstract
PURPOSE: To evaluate whether deep pelvic endometriosis or endometriomas diagnosed at pelvic MRI are associated with extrapelvic bowel endometriosis (EPBE) (ileal, appendicular, or cecal involvement) in order to suggest criteria for performing an additional imaging examination dedicated to the assessment of EPBE. METHODS: Ninety-six patients operated on for deep pelvic endometriosis were retrospectively included. They were classified in two groups according to the presence of surgically and histologically proven EPBE. According to pelvic endometriotic lesions described on the preoperative pelvic MRI, a logistic regression analysis was performed to evaluate a possible association between EPBE and pelvic endometriosis. RESULTS: Eleven patients had EPBE (5 appendicular, 2 cecal, and 4 ileocecal lesions) at surgery. In adjusted models, involvement of the right ureter, rectosigmoid, and sigmoid localizations were statistically associated with EPBE with adjusted OR of 9.13 (95% CI 1.98-42.19), 5.8 (95% CI 1.12-30.07), and 6.74 (95% CI 1.23-36.77), respectively. CONCLUSIONS: Further imaging evaluation to assess ileal, appendicular, or cecal endometriosis should be proposed in case of sigmoid or rectosigmoid endometriosis diagnosed at pelvic MRI. A right ureteral lesion diagnosed preoperatively should be considered carefully as its association with EPBE is not described so far.
PURPOSE: To evaluate whether deep pelvic endometriosis or endometriomas diagnosed at pelvic MRI are associated with extrapelvic bowel endometriosis (EPBE) (ileal, appendicular, or cecal involvement) in order to suggest criteria for performing an additional imaging examination dedicated to the assessment of EPBE. METHODS: Ninety-six patients operated on for deep pelvic endometriosis were retrospectively included. They were classified in two groups according to the presence of surgically and histologically proven EPBE. According to pelvic endometriotic lesions described on the preoperative pelvic MRI, a logistic regression analysis was performed to evaluate a possible association between EPBE and pelvic endometriosis. RESULTS: Eleven patients had EPBE (5 appendicular, 2 cecal, and 4 ileocecal lesions) at surgery. In adjusted models, involvement of the right ureter, rectosigmoid, and sigmoid localizations were statistically associated with EPBE with adjusted OR of 9.13 (95% CI 1.98-42.19), 5.8 (95% CI 1.12-30.07), and 6.74 (95% CI 1.23-36.77), respectively. CONCLUSIONS: Further imaging evaluation to assess ileal, appendicular, or cecal endometriosis should be proposed in case of sigmoid or rectosigmoid endometriosis diagnosed at pelvic MRI. A right ureteral lesion diagnosed preoperatively should be considered carefully as its association with EPBE is not described so far.
Entities:
Keywords:
Bowel; Deep infiltrating endometriosis; Ileocecal; Magnetic resonance imaging; Sigmoid