肠道子宫内膜异位症的超声诊断。

IF 2 4区 医学 Q2 OBSTETRICS & GYNECOLOGY
Simone Ferrero, Fabio Barra, Umberto Perrone, Michele Paudice, Valerio Gaetano Vellone
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引用次数: 0

摘要

背景 肠道子宫内膜异位症是深部子宫内膜异位症中较为严重的一种表现,可引起疼痛和肠道症状。肠道子宫内膜异位症的无创诊断对于计划治疗受此疾病影响的患者至关重要。目的 本综述旨在描述经阴道超声检查(TVS)在怀疑直肠乙状结肠子宫内膜异位症患者中的应用方式、诊断效果以及该技术的优势和局限性。方法 为了确定相关文献,我们在 PubMed 和 Google Scholar 数据库中进行了文献检索,检索时间截至 2024 年 7 月。结果 大量荟萃分析表明,TVS 在诊断直肠乙状结肠子宫内膜异位症方面具有很高的诊断准确性。直肠乙状结肠结节可表现出不同的形态特征,但通常被描述为位于直肠乙状结肠前壁的不规则、低回声结节。阴性滑动征和亲吻卵巢等 "软标志物 "的出现可进一步强化该病症的诊断。宫旁后外侧受累常与直肠大结节同时存在。将水造影剂引入直肠乙状结肠并不能提高 TVS 诊断直肠乙状结肠子宫内膜异位症的效果。结论与展望 TVS 应作为疑似直肠乙状结肠子宫内膜异位症妇女的一线检查方法。广泛使用 TVS 诊断肠道子宫内膜异位症可减少诊断延误,促进对该病患者的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ultrasound Diagnosis of Bowel Endometriosis.

Background: Bowel endometriosis is one of the more severe manifestations of deep endometriosis; it may cause pain and intestinal symptoms. The noninvasive diagnosis of bowel endometriosis is of crucial importance in planning the management of patients affected by this condition.

Objectives: This review aims to describe how transvaginal ultrasonography (TVS) is performed in patients with suspicion of rectosigmoid endometriosis, the diagnostic performance, and the strengths and limitations of this technique.

Methods: To identify relevant literature, a literature search was performed across the PubMed and Google Scholar databases up to July 2024.

Outcome: Numerous meta-analyses have demonstrated that TVS has high diagnostic accuracy in diagnosing rectosigmoid endometriosis. Rectosigmoid nodules can present with different morphological characteristics, but they are typically described as irregular, hypoechoic nodules located in the anterior wall of the rectosigmoid colon. The presence of "soft markers," such as a negative sliding sign and kissing ovaries, can further reinforce the diagnosis of this condition. Posterolateral parametrial involvement often coexists with large rectal nodules. Introducing water contrast into the rectosigmoid does not improve the performance of TVS in diagnosing rectosigmoid endometriosis.

Conclusions and outlook: TVS should be the first-line investigation in women suspected of having rectosigmoid endometriosis. The widespread use of TVS for the diagnosis of intestinal endometriosis can reduce diagnostic delays and facilitate the treatment of patients affected by this condition.

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来源期刊
CiteScore
4.20
自引率
4.80%
发文量
44
审稿时长
6-12 weeks
期刊介绍: This journal covers the most active and promising areas of current research in gynecology and obstetrics. Invited, well-referenced reviews by noted experts keep readers in touch with the general framework and direction of international study. Original papers report selected experimental and clinical investigations in all fields related to gynecology, obstetrics and reproduction. Short communications are published to allow immediate discussion of new data. The international and interdisciplinary character of this periodical provides an avenue to less accessible sources and to worldwide research for investigators and practitioners.
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