Uro-colon CT in the diagnosis of pelvic deep infiltrating endometriosis. .

Purpose: To evaluate the diagnostic accuracy (DA) of the uro-colon-CT (UCCT) with dose-reduction dedicated protocol in preoperative study of deep infiltrating endometriosis of the anterior and posterior compartments (aDIE and/or pDIE). Methods and Materials: 73 patients with clinical suspicion of aDIE and/or pDIE were analysed retrospectively, undergone U-CCT between January 2012 and December 2014 before laparoscopic surgery, and imaging data were compared with the surgical and histological reports. We calculated sensitivity, specificity, PPV, NPV of U-CCT and evaluated the utility of this technique to select patients who need a more detailed presurgical planning. Results: 74 surgical interventions were performed on 73 patients (one patient was exposed to surgery twice due to DIE relapse after two years). In 4/74 surgical interventions U-CCT with dose-reduction dedicated protocol was negative for DIE. The urologists were properly involved when DIE nodules concerning ureters and bladder (p=0,042); The colorectal surgeons were more often involved when DIE nodules concerning sigmoid colon, particularly in case of bowel stenosis >50% (p=0,031%). U-CCT attested better results in the evaluation of DIE nodules involving digestive tract (DA 81%; p=0,000) and bladder (DA 87,8%; p=0,000). Conclusion: U-CCT with dose-reduction dedicated protocol proved to be a valid alternative to barium-enema x-ray and urography or in absence of MRI with targeted protocol, to elaborate a detailed presurgical planning in selected patients with DIE; in particular this method is very helpful to individuate DIE nodules involving digestive tract or bladder and to evaluate the correct involvement of the urologist and/or the colorectal surgeon.