Diagnosis of endometriosis: pelvic endoscopy and imaging techniques
Diagnosis of endometriosis: pelvic endoscopy and imaging techniques
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DOI：
10.1016/j.bpobgyn.2004.03.002
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发表时间：
2004-04-01
影响因子：
5.5
通讯作者：
Gordts, S
中科院分区：
文献类型：
--
作者：
Brosens, I;Puttemans, P;Gordts, S
虽然腹腔镜检查是诊断子宫内膜异位症的金标准，但对这种侵入性诊断工具的需求是有效临床管理和研究这种常见和衰弱疾病的主要绊脚石。由于骨盆的肉眼检查也有很大的局限性，特别是对于骨盆后部、肠和膀胱子宫内膜异位症的诊断，因此人们正在努力通过影像学技术来提高诊断水平，这并不奇怪。腹膜子宫内膜异位症和卵巢子宫内膜瘤主要是出血性病变。在腹腔镜检查中，这些病变很容易通过旧的或最近的出血来识别。经阴道超声和磁共振（MR）成像诊断腹膜和卵巢种植体和粘连的敏感性较低。经阴道超声检查对诊断直径大于2cm的卵巢腺瘤是有用的。由于经阴道超声检查比磁共振成像费用低，经阴道超声检查可能是确定较大子宫内膜异位瘤的首选方法。高分辨率经阴道超声，特别是磁共振成像，越来越多地用于诊断浸润性病变的存在和范围以及直肠乙状结肠和输尿管的受累。
Although laparoscopy is the gold standard for the diagnosis of endometriosis, the need for this invasive diagnostic tool is a major stumbling-block in both effective clinical management and for research into this common and debilitating disease. As visual inspection of the pelvis has also major limitations, particularly for the diagnosis of posterior pelvis, bowel and bladder endometriosis, it is not surprising that considerable efforts are being made to improve the diagnosis by imaging techniques.Peritoneal endometriosis and ovarian endometriomata are predominantly haemorrhagic lesions. During laparoscopy, these lesions are readily identified by the presence of old or recent bleeding. Both transvaginal sonography and magnetic resonance (MR) imaging have a low sensitivity for the diagnosis of peritoneal and ovarian implants and adhesions. Transvaginal sonography is useful in the diagnosis of ovarian endometriomata, providing the diameter is larger than 2 cm. As transvaginal sonography costs less than MR imaging, transvaginal sonography might be the preferred method of confirming a sizeable endometrioma.Posterior pelvis endometriosis is an infiltrating adenomyotic lesion with microendometriomata. High-resolution transvaginal ultrasonography, and in particular MR imaging, are increasingly used to diagnose the presence and extent of infiltrating lesions and the involvement of rectosigmoid and ureters.