Qualidade da imagem nas pacientes com suspeita de Endometriose infiltrada profunda : comparação entre a ultrassonografia transvaginal antes e após a realização do preparo retal

• Autor(a) principal: Mendonça, Juliana Vieira de
• Data de Publicação: 2011
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/8719
• topic: deep infiltrating endometriosis; endometriosis of the posterior compartment; phosphate enema; bowel preparation; endometriose; ultrassonografia; diagnóstico por imagens; Enema; endometriose infiltrativa profunda; endometriose de compartimento posterior; enema retal; preparo intestinal; CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::GINECOLOGIA E OBSTETRICIA

To compare image quality between the transvaginal ultrasound without bowel preparation and after bowel preparation in patients with suspected deep infiltrating endometriosis of the posterior compartment and evaluate the degree of discomfort of patients in relation to bowel preparation. Cross sectional data collected prospectively, including 39 patients with clinical suspicion of endometriosis of the posterior compartment of the endometriosis clinic of the Hospital Universitário Pedro Ernesto (HUPE) State University of Rio de Janeiro (UERJ), in Rio de Janeiro . The patients underwent transvaginal sonography (USTVG) without prior bowel preparation, followed by new USTVG one hour after completion of the rectal enema. The recorded videos of the tests were published, with emphasis on evaluation of the posterior compartment, with interest in the identification of the nodule retrocervical and rectosigmoid. Were graded according to the quality of the image by the examiner and by a radiologist (both masked), which marked a score from 0 to 10, using the visual analog scale. That left only 26 patients. Regarding the realization of discomfort due to rectal enema, all patients (100%) reported only mild discomfort. Depending on the option chosen by the evaluators regarding the best method, they agreed in 13 (50%) patients with transvaginal ultrasound rectal preparation is better. We used the nonparametric Wilcoxon test for dependent samples. The p-value obtained was 0042 and considered significant (less than 0.05). This means that the completion of rectal enema prior to the transvaginal ultrasound provided a better quality in the evaluation of nodules. The difference between evaluations with and without rectal preparation is higher in nodules smaller than 2 cm, because we found a difference of 1.1 between the median values of the two types of tests. In nodules larger than 2cm, the difference was only 0.65. The performance of the rectal enema prior to the performance of transvaginal sonography in the diagnosis of endometriotic nodule shows a slightly significant improvement in image quality, compared to non-completion of bowel preparation prior. Only in cases where the lump was less than 2 cm were found statistically significant values with rectal preparation. The rectal enema cause mild discomfort, but this does not seem to be a limiting factor in the performance of ultrasound with bowel preparation