Poster électronique

Intérêt du scanner avec double opacification dans le diagnostic d'endométriose pelvienne et digestive
F. Ferreira, J. Uzan-Augui, AE. Millischer-Bellaiche, B. Dousset, C. Chapron, O. Vignaux, P. Legmann - Paris - France
Congrès 2011
Résumé
Objectifs
Evaluer prospectivement la performance du scanner dans le diagnostic préopératoire d'endométriose pelvienne et digestive, en comparaison avec l'IRM, l'échographie et l'échoendoscopie rectale.
Matériels et méthodes
L'IRM, l'échographie endovaginale, l'échoendoscopie et le scanner étaient réalisés chez 117 patientes. Deux radiologues ont évalué de manière indépendante l'IRM et le scanner. L'échographie était réalisée par l'un des deux. L'échoendoscopie était réalisée par un gastroentérologue. Les examens étaient relus par un radiologue junior. Toutes les patientes étaient opérées.
Résultats
Atteintes rectales : sensibilité (Se)89%, specificité (Sp)89% au scanner, Se94%, Sp89%, pour l'IRM Se92%, Sp100% pour l'échographie endovaginale, Se100%, Sp93% pour l'échoendoscopie rectale, kappa junior-senior : scanner=0,88, IRM=0,72. Atteintes sigmoïdiennes : Se89%, Sp61% pour le scanner, Se74%, Sp83% pour l'IRM, Se85%, Sp39% pour l'échographie endovaginale, Se100%, Sp93% pour l'échoendoscopie rectale, kappa junior-senior : scanner=0,88, IRM=0,72. Atteintes iléocaecales : Se29% et Sp96% pour le scanner, Se19%, Sp100% pour l'IRM, Se14%, Sp100% pour l'échographie, kappa junior-senior : scanner=0,57, IRM=0,55. Atteintes appendiculaires seulement vues au scanner. Résultats variables pour les autres localisations.
Conclusion
Le scanner est un examen sensible et spécifique, dans le diagnostic d'endométriose digestive, notamment pour les atteintes sigmoïdiennes et digestives hautes. Ces lésions sont sous-estimées par l'IRM et l'échoendoscopie. Le scanner a donc un intérêt dans le bilan préopératoire. L'ensemble des atteintes d'endométriose profonde peuvent être évoquées au scanner, sur des examens réalisés pour des indications diverses, y compris par un médecin peu expérimenté.
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2018-11-05 13.59 :
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2017-12-08 13.57 :
Win Like 82

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2011-10-22 12.23 :
constantinescu

Très bon travail, utile.Merci
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