Balleyguier C, Chapron C, Chopin N, Hélénon O, Menu Y
Assistance Publique-Hôpitaux de Paris, Service de radiologie, CHU Necker, Paris, France.
Gynecol Obstet Invest. 2003;55(4):220-4. doi: 10.1159/000072078.
Scar endometriosis is a rare disease which is difficult to diagnose. The symptoms are nonspecific, typically involving abdominal wall pain at the time of menstruation. Clinical examination may reveal a painful nodule, if the scar involved is located on the abdominal wall, but is normal, when the lesion is located on the uterine scar. Other means of investigation (transvaginal ultrasonography, computed tomography) may be useful in case of lesions on the abdominal wall, or if the nodule is large, but give no specific results. The diagnosis is frequently made only after excision of the lesion. We report here 4 patients operated for scar endometriosis (two abdominal and two uterine scars) for whom MRI had suggested the diagnosis. Thanks to its very high spatial resolution, MRI enables very small lesions to be detected and can distinguish the hemorrhagic signal of endometriotic lesions. Furthermore, it performs better than the CT scan in detecting the limits between muscles and abdominal subcutaneous tissues.
瘢痕子宫内膜异位症是一种罕见疾病，诊断困难。其症状不具特异性，通常在月经期间出现腹壁疼痛。临床检查时，如果受累瘢痕位于腹壁，可能会发现疼痛性结节；而当病变位于子宫瘢痕时，检查结果则正常。对于腹壁病变或结节较大的情况，其他检查手段（经阴道超声检查、计算机断层扫描）可能有用，但不会给出特异性结果。通常只有在病变切除后才能确诊。我们在此报告4例因瘢痕子宫内膜异位症接受手术的患者（2例腹壁瘢痕和2例子宫瘢痕），其磁共振成像（MRI）提示了诊断。由于MRI具有非常高的空间分辨率，能够检测到非常小的病变，并可区分子宫内膜异位病变的出血信号。此外，在检测肌肉与腹部皮下组织之间的界限方面，MRI比计算机断层扫描表现更好。
