Hensen Jan-Hein J, Van Breda Vriesman Adriaan C, Puylaert Julien B C M
Department of Radiology, MCH Westeinde Hospital, The Hague, Lijnbaan 32, PO Box 432, NL-2501 CK, The Netherlands.
AJR Am J Roentgenol. 2006 Mar;186(3):616-20. doi: 10.2214/AJR.04.1619.
The purpose of our study was to evaluate clinical findings and sonographic features of abdominal wall endometriosis and also to report its CT and MR appearance.
A computerized search of our institution's database over a 5-year period was performed, yielding 12 surgically proven cases of abdominal wall endometriosis that were retrospectively studied. All patients had undergone sonography including power Doppler examination. Additional CT was performed in one patient and MRI in four. Pathologic material was preoperatively obtained by sonographically guided puncture in six patients. The clinical data were analyzed, and the imaging studies were reviewed by two radiologists working in consensus.
All patients had a history of at least one prior cesarean section. All presented with focal pain near the surgical scar, which was cyclic in three patients. Nine patients presented with a palpable mass near the scar. Sonography detected 11 lesions within the abdominal wall, with a mean diameter of 25 mm. All lesions were hypoechoic, vascular, and solid, with some cystic changes in one. The calculated frequency of abdominal wall endometriosis is approximately 0.8% of all women who had a cesarean delivery.
Abdominal wall endometriosis frequently presents with noncyclic symptoms. Imaging findings of a solid mass near a cesarean section scar strongly suggest its diagnosis.
本研究旨在评估腹壁子宫内膜异位症的临床症状及超声特征，并报告其CT及MR表现。
对我院数据库进行为期5年的计算机检索，筛选出12例经手术证实的腹壁子宫内膜异位症病例并进行回顾性研究。所有患者均接受了包括能量多普勒检查在内的超声检查。1例患者接受了CT检查，4例接受了MRI检查。6例患者术前通过超声引导穿刺获取病理材料。分析临床资料，由两位放射科医生共同回顾影像学检查结果。
所有患者均有至少一次剖宫产史。所有患者均表现为手术瘢痕附近的局限性疼痛，其中3例呈周期性疼痛。9例患者在瘢痕附近可触及肿块。超声检查发现腹壁内11个病灶，平均直径25mm。所有病灶均为低回声、有血管且为实性，其中1个有一些囊性改变。腹壁子宫内膜异位症的计算发病率约为所有剖宫产女性的0.8%。
腹壁子宫内膜异位症常表现为非周期性症状。剖宫产瘢痕附近实性肿块的影像学表现强烈提示该病的诊断。
