肠内膜异位症:系统的超声和MRI诊断方法。

IF 5.2 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Radiographics Pub Date : 2025-04-01 DOI:10.1148/rg.240102
Haatal B Dave, Luciana P Chamié, Scott W Young, Michelle D Sakala, Wendaline M VanBuren, Priyanka Jha, Luyao Shen, Melina Pectasides, Peter Movilla, Sherelle Laifer-Narin, Phyllis Glanc, Anuradha S Shenoy-Bhangle
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引用次数: 0

摘要

累及肠道的子宫内膜异位症是该病的一种严重形式,而肠道是子宫外子宫内膜异位症最常见的部位。肠表面病变被认为是腹膜性疾病。肠内膜异位症(BE)被定义为浸润肠壁固有肌层的子宫内膜异位症组织。据估计,多达37%的已知深部子宫内膜异位症患者会受到BE的影响,这突出了它与生殖器子宫内膜异位症的共存。直肠乙状结肠是最常见的肠段,其次是远端小肠。超声和核磁共振成像是检测BE最常用的成像方式。根据肠段的不同,最常用的子宫内膜异位症方案是在经腹成分肠准备后经阴道超声检查,以及MRI和MR肠造影。作者提供了一个系统的方法来诊断使用这些成像模式的BE。讨论了肠可视化的成像方案和优化技术,描述了两种成像方式下的正常肠壁解剖,并说明了子宫内膜异位症对肠壁的不同程度的损害。详细描述肠固有肌层浸润子宫内膜异位症的影像学特征,并将关键影像学发现告知外科同事,以优化手术治疗,减少并发症,从而改善患者的整体预后。©RSNA, 2025本文可获得补充材料。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bowel Endometriosis: Systematic Approach to Diagnosis with US and MRI.

Endometriosis involving the bowel is a severe form of the disease, and the bowel is the most common site of extragenital endometriosis. Surface lesions of the bowel are considered peritoneal disease. Bowel endometriosis (BE) is defined as endometriotic tissue infiltrating the muscularis propria layer of the bowel wall. BE is estimated to affect up to 37% of patients with known deep endometriosis, highlighting its coexistence with genital endometriosis. The rectosigmoid colon is the most common segment of the bowel involved, followed by the distal small bowel. US and MRI are the most common imaging modalities used to detect BE. Depending on which bowel segment is imaged, endometriosis protocols for transvaginal US after bowel preparation with a transabdominal component and MRI and MR enterography are most commonly used. The authors provide a systematic approach to the diagnosis of BE using these imaging modalities. Imaging protocols and techniques for optimization of visualization of the bowel are discussed, the normal bowel wall anatomy with both imaging modalities is described, and the varying degrees of bowel wall involvement in endometriosis are illustrated. The imaging features of infiltration of endometriosis in the bowel muscularis propria are described in detail, along with key imaging findings to be conveyed to surgical colleagues to optimize surgical treatment and decrease complications, thereby improving overall patient outcomes. ©RSNA, 2025 Supplemental material is available for this article.

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来源期刊
Radiographics
Radiographics 医学-核医学
CiteScore
8.20
自引率
5.50%
发文量
224
审稿时长
4-8 weeks
期刊介绍: Launched by the Radiological Society of North America (RSNA) in 1981, RadioGraphics is one of the premier education journals in diagnostic radiology. Each bimonthly issue features 15–20 practice-focused articles spanning the full spectrum of radiologic subspecialties and addressing topics such as diagnostic imaging techniques, imaging features of a disease or group of diseases, radiologic-pathologic correlation, practice policy and quality initiatives, imaging physics, informatics, and lifelong learning. A special issue, a monograph focused on a single subspecialty or on a crossover topic of interest to multiple subspecialties, is published each October. Each issue offers more than a dozen opportunities to earn continuing medical education credits that qualify for AMA PRA Category 1 CreditTM and all online activities can be applied toward the ABR MOC Self-Assessment Requirement.
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