Focus on Adenomyosis
Focus on Adenomyosis
复制标题
DOI：
10.1016/j.diii.2012.10.012
复制
发表时间：
2013-01-01
影响因子：
--
通讯作者：
Poncelet, E.
中科院分区：
文献类型：
--
作者：
Levy, G.;Dehaene, A.;Poncelet, E.
子宫腺肌病是一种常见的良性子宫病理，其定义是子宫肌层内存在异位内膜岛状组织。三分之一的病例没有症状，但当有临床症状时，它们仍然是非特异性的。超声检查常误诊为多发性子宫肌瘤或子宫内膜增厚，两者的预后和治疗方法不同。子宫腺肌症通常与激素依赖性盆腔病变(肌瘤、子宫内膜异位症或子宫内膜增生症)有关。它与不孕不育或产科并发症的联系较少，事实上，任何直接关系仍然存在争议。成像的目的是做出诊断，确定扩散的程度(局灶性或弥漫性、浅表性或深深性子宫腺肌病、子宫腺肌瘤)，并检查是否有任何相关疾病，特别是子宫内膜异位症。本文的目的是在影像上对子宫腺肌病的认识提供帮助，并找出与子宫腺肌病相关的常见病理，以指导有症状患者的治疗。盆腔超声检查是一线检查。在某些情况下，超声宫腔造影术有助于诊断(超声上可见子宫内膜假性颤动)。除了超声检查外，还可以使用核磁共振成像来支持诊断并寻找任何相关疾病。
Adenomyosis is a common benign uterine pathology that is defined by the presence of islands of ectopic endometrial tissue within the myometrium. It is asymptomatic in one third of cases, but when there are clinical signs they remain non-specific. It can often be misdiagnosed on sonography as it may be taken to be multiple uterine leiomyomata or endometrial thickening, both of which have a different prognosis and treatment. Adenomyosis is often associated with hormone-dependent pelvic lesions (myoma, endometriosis, or endometrial hyperplasia). It is less commonly connected to infertility or obstetrical complications and indeed any direct relationship remains controversial. The purpose of imaging is to make the diagnosis, to determine the extent of spread (focal or diffuse, superficial or deep adenomyosis, adenomyoma), and to check whether there is any associated disease, in particular endometriosis. The aim of this article is to provide assistance in recognising adenomyosis on imaging and to identify the pathologies that are commonly associated with it in order to guide the therapeutic management of symptomatic patients. Pelvic ultrasonography is the first line investigation. Sonohysterography can assist with diagnosis in some cases (pseudothickening of the endometrium seen on sonography). MRI may be used in addition to sonography to back up the diagnosis and to look for any associated disease.