Endometriosis is a condition in which tissue resembling the endometrium — the tissue that lines the uterus — starts growing outside the uterus, forming lesions, usually in other areas of the pelvis. These lesions may also grow on the bowel or bladder. They swell and shed, just like the normal endometrial tissue, but cannot be expelled properly from the body. This leads to inflammation, pain, and in more severe cases, infertility.
What is a computerized tomography (CT) scan?
A computerized tomography (CT) scan is an imaging technique that combines a series of detailed X-ray images, taken from different angles to get cross-sectional pictures of the blood vessels, bones, and internal organs.
CT scans and the diagnosis of endometriosis
CT scans can be used to visualize endometriosis in some areas of the abdomen, but are not very efficient in visualizing the pelvic organs, such as the uterus. However, they can be used to detect ureteral involvement in endometriosis — endometrial lesions obstructing or constricting the ureters, or the tubes that connect the kidneys to the bladder — and kidney problems associated with the condition.
What to expect during a CT scan
For the CT scan, the patient lies on a table, which slides into a large donut-shaped machine that takes the images. The patient is exposed to small amounts of ionizing radiation, slightly more than the exposure during a conventional X-ray scan because more information is being collected.
Before some CT scans, patients may need to drink a contrast fluid, which better highlights particular areas of the body. In other cases, the contrast agent is injected in the bloodstream or inside the rectum by enema. Most patients have mild or no reactions to this agent.
The procedure, which is painless, is available in hospitals as well as outpatient facilities and typically takes about 30 minutes.
After the scan
After the scan, patients may be asked to wait for a few minutes to make sure they have no reactions to the contrast agent. Patients are encouraged to drink a lot of fluids after the scan to help their kidneys clear the contrast agent.
The results are examined by a radiologist, who will discuss them with the doctor who ordered the scan. The doctor will then relay the results of the scan to the patient.
The results of the scan
For patients with endometriosis, the CT scan may reveal endometrial lesions on the ureters or kidneys, or on the abdominal wall. If so, the doctor may recommend a laparoscopy to confirm the diagnosis and remove the lesions.
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