计算机断层扫描在子宫内膜异位症成像中的作用。

IF 2.2 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Soumyadeep Ghosh, Ahmad Alhamshari, Priyanka Prajapati, Nabih Nakrour, Carlos Carnelli, Aoife Kilcoyne, Mukesh G. Harisinghani, Leo L. Tsai, Onofrio A. Catalano, Avinash Kambadakone, Anuradha S. Shenoy-Bhangle
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引用次数: 0

摘要

子宫内膜异位症是一种慢性全身性疾病,其特征是子宫外存在子宫内膜样腺体和/或间质,通常伴有相关炎症过程。它影响全世界约5-10%的妇女,慢性盆腔疼痛和不孕是主要症状。尽管临床上怀疑,经阴道超声(TVUS)和磁共振成像(MRI)是诊断盆腔子宫内膜异位症的主要成像工具,也有助于术前定位。计算机断层扫描(CT)不是检测或描述疾病程度的首选成像方式。然而,在出现急性或非特异性腹部/骨盆疼痛的女性中,腹部和骨盆的CT常被作为最初的影像学检查。子宫内膜异位症的CT表现因受累器官的不同而不同,由于其非特异性的CT表现和与其他病理的重叠,往往不能正确诊断。卵巢子宫内膜异位症(Ovarian endometriomas, OMAs)是最常见的子宫内膜异位症表型,可表现为位于卵巢预期位置或位于子宫后方的高密度附件肿块。子宫内膜瘤可能破裂,表现为腹腔积血。深子宫内膜异位症可使子宫扭曲,并沿子宫后表面剧烈后屈。子宫内膜异位症可影响肠道,尤其是直肠乙状结肠,表现为增强子宫后表面与直肠前壁之间的软组织桥接。小肠受累可表现为复发性小肠梗阻。累及泌尿系统可表现为输尿管梗阻或膀胱壁肿块。鉴于这些不同的表现,需要高度的临床怀疑和对提示子宫内膜异位症的CT特征的了解,以促进早期诊断。因此,本文综述了子宫内膜异位症在腹腔CT上的影像学表现,目的是减少对准确诊断的延误,改善患者的长期预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of computed tomography in imaging of endometriosis

Endometriosis is a chronic systemic disease characterized by the presence of endometrium-like glands and/or stroma outside the uterus, usually with an associated inflammatory process. It affects around 5–10% of women worldwide, with chronic pelvic pain and infertility being the predominant symptoms. Although suspected clinically, transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) are the primary imaging tools for diagnosing pelvic endometriosis, as well as helping in pre-surgical mapping. Computed tomography (CT) is not the preferred imaging modality for detection or depiction of disease extent. However, CT of the abdomen and pelvis is often performed as the initial imaging test in women presenting with acute or non-specific abdominal/ pelvic pain. CT features of endometriosis can vary depending on the organ affected, and the correct diagnosis is often not suspected due to its nonspecific CT appearance and overlap with other pathologies. Ovarian endometriomas (OMAs), the most recognized phenotype of endometriosis, may appear as hyperdense adnexal masses either in the expected location of the ovaries or positioned posterior to the uterus. Endometriomas may rupture, presenting with hemoperitoneum. The uterus may be distorted and acutely retroflexed from deep endometriosis along the posterior uterine surface. The bowel can be affected by endometriosis, especially the rectosigmoid colon, presenting as enhancing soft tissue bridging from the posterior uterine surface to the anterior rectal wall. Small bowel involvement may present with recurrent small bowel obstructions. Involvement of the urinary system may present with ureteral obstruction or a bladder wall mass. Given such varied appearances, a high degree of clinical suspicion and knowledge of CT features suggestive of endometriosis is required to facilitate an early diagnosis. This review paper therefore describes the imaging findings of endometriosis that can be recognized on an abdominopelvic CT, with the goal of decreasing the existing delay to accurate diagnosis and improving long term patient outcomes.

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来源期刊
Abdominal Radiology
Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
5.20
自引率
8.30%
发文量
334
期刊介绍: Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits
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