MR imaging findings of adenomyosis: Correlation with histopathologic features and diagnostic pitfalls
MR imaging findings of adenomyosis: Correlation with histopathologic features and diagnostic pitfalls
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DOI：
10.1148/rg.251045060
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发表时间：
2005-01-01
期刊：
影响因子：
5.5
通讯作者：
Koyama, T
中科院分区：
文献类型：
--
作者：
Tamai, K;Togashi, K;Koyama, T
子宫腺肌病是一种非肿瘤性疾病，其特征是异位子宫内膜良性侵入子宫肌层并伴有邻近平滑肌增生。常见的症状包括痛经、月经过多和异常子宫出血，但这些都不允许诊断。因此，影像学起着重要的作用，因为建立正确的术前诊断是至关重要的，以避免不必要的干预。磁共振（MR）成像是一种高度准确的非侵入性方式，用于诊断子宫腺肌病，区分子宫腺肌病与其他妇科疾病，并制定适当的治疗计划。虽然典型的MR影像学表现已被证实，但子宫腺肌病在组织病理学特征（腺体稀疏的子宫腺肌病）、生长方式（息肉样腺肌瘤、子宫腺肌病囊肿和小型子宫）、对激素活性的反应（他莫昔芬、蜕膜变化）和对治疗的反应（促性腺激素释放激素激动剂）方面实际上有很大差异。子宫腺肌症的磁振造影表现有时与子宫恶性肿瘤或卵巢癌相似。此外，在良性子宫腺肌病中偶尔会发展为恶性。子宫腺肌病的诊断包括子宫肌层收缩、平滑肌瘤、腺瘤样瘤、转移瘤、子宫内膜癌和子宫内膜间质肉瘤。了解子宫腺肌病的各种表现以及鉴别诊断中可能存在的陷阱有助于指导确定适当的治疗方案。(C)RSNA，2005年。
Adenomyosis is a nonneoplastic condition, characterized by benign invasion of ectopic endometrium into the myometrium with hyperplasia of adjacent smooth muscle. The common symptoms include dysmenorrhea, menorrhagia, and abnormal uterine bleeding, but these do not allow diagnosis. Therefore, imaging plays an important role because establishment of the correct preoperative diagnosis is critical to avoid unnecessary intervention. Magnetic resonance (MR) imaging is a highly accurate noninvasive modality for diagnosis of adenomyosis, differentiation of adenomyosis from other gynecologic disorders, and planning of appropriate treatment. Although the typical MR imaging findings are well established, adenomyosis actually varies widely in terms of histopathologic features (adenomyosis with sparse glands), growth patterns (polypoid adenomyoma, adenomyotic cyst, and miniature uterus), responses to hormonal activity (tamoxifen, decidual changes), and responses to treatment (gonadotropin-releasing hormone agonist). The MR imaging findings of adenomyosis occasionally mimic those of uterine malignancy or ovarian cancer. Furthermore, malignancy occasionally develops in otherwise benign adenomyosis. Pitfalls in diagnosis of adenomyosis include myometrial contractions, leiomyoma, adenomatoid tumor, metastases, endometrial carcinoma, and endometrial stromal sarcoma. Knowledge of the various appearances of adenomyosis and the possible pitfalls in differential diagnosis help guide the determination of appropriate treatment options. (C) RSNA, 2005.