A Detailed Study in Adenomyosis and Endometriosis: Evaluation of the Rate of Coexistence Between Uterine Adenomyosis and DIE According to Imaging and Histopathology Findings
A Detailed Study in Adenomyosis and Endometriosis: Evaluation of the Rate of Coexistence Between Uterine Adenomyosis and DIE According to Imaging and Histopathology Findings
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DOI：
10.1007/s43032-021-00527-0
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发表时间：
2021-03-16
影响因子：
2.9
通讯作者：
Shahraki, Hadi Raeisi
中科院分区：
文献类型：
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作者：
Alborzi, Saeed;Askary, Elham;Shahraki, Hadi Raeisi
本研究旨在评估子宫腺肌症及其亚型与子宫内膜异位症病变（卵巢子宫内膜异位症（OMAs）和后深浸润性子宫内膜异位症（DIE））的关系，探讨这些神秘疾病存在共同病因的可能性，并评估经阴道超声检查（TVS）和MRI诊断子宫腺肌病的准确性、敏感性和特异性。在这项回顾性横断面研究中，我们根据影像、术中或病理结果选择了154名子宫内膜异位症和子宫腺肌症共存的女性，并提名她们进行腹腔镜手术。单纯DIE切除不加LH（腹腔镜子宫切除术）86例（第一组），LH + DIE切除68例（第二组）。超声和MRI诊断子宫腺肌症的准确性、敏感性和特异性分别为72.1%、77.6%、40.0%和49.2%、41.5%、90.0%。因此，TVS是诊断bb0更为灵敏的诊断工具。然而，MRI对弥漫性脑卒中的诊断比TVS更特异，尤其是同时伴有子宫平滑肌瘤时。关于不同类型的子宫腺肌症（局灶性和弥漫性）与不同子宫内膜异位症病变（OMA和后腔室DIE）的关系，我们刚刚发现弥漫性子宫腺肌症在没有直肠和直肠阴道间隔（RVS） DIE的情况下更为常见(p
The current study was designed to evaluate the relationship between adenomyosis and its subtypes with endometriotic lesions (ovarian endometrioma (OMAs) and posterior deep infiltrative endometriosis (DIE)), to examine the probability of existence of a common cause of these mysterious diseases, and to evaluate the accuracy, sensitivity, and specificity of both transvaginal ultrasonography (TVS) and MRI in diagnosis of adenomyotic uterus. In this retrospective cross-sectional study, we selected 154 women with coexistence of endometriosis and adenomyosis according to their imaging, intraoperative, or pathological findings who were nominated for laparoscopic surgery. Eighty-six patients with just DIE resection without LH (laparoscopic hysterectomy) (group 1), and 68 patients with LH + DIE resection (group 2). The accuracy, sensitivity, and specificity of ultrasonographic and MRI findings for diagnosing adenomyosis were 72.1%, 77.6%, 40.0% and 49.2%, 41.5%, 90.0% respectively. So, TVS is a more sensitive diagnostic tool for diagnosing adenomyosis. However, MRI was more specific than TVS in the diagnosis of diffuse adenomyosis especially with simultaneous presence of uterine leiomyoma. Regarding the association of different types of adenomyosis (focal and diffuse) with different endometriosis lesions (OMA and posterior compartment DIE), we just found diffuse type of adenomyosis more frequent in the absence of rectal and rectovaginal septum (RVS) DIE (p