Peri Nagamani, Levine Deborah
Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.
J Ultrasound Med. 2007 Jan;26(1):55-8; quiz 59-60. doi: 10.7863/jum.2007.26.1.55.
The purpose of this study was to assess the incidence and significance of a thick, cystic-appearing endometrium in association with a history or an ovarian appearance of polycystic ovarian syndrome.
An Institutional Review Board-approved, retrospective medical record review of sonographic studies from January 1, 1998, to December 31, 2005, found 245 patients with clinical features, a characteristic sonographic appearance of the ovaries, hormonal abnormalities, or a history of polycystic ovarian syndrome. The sonographic thickness and appearance of the endometrium (homogeneous or heterogeneous) and histologic findings on biopsy were obtained.
Two hundred twenty-seven patients had a homogeneous endometrium in the range of 1 to 17 mm (mean +/- SD, 6.4 +/- 3.1 mm); 18 patients had a heterogeneous endometrium in the range of 4 to 23 mm (mean, 13.2 +/- 5.6 mm). Of the 18 patients with a heterogeneous endometrium, 9 also had a sonographic finding of tiny cystic foci within the endometrium. Of these, 5 had endometrial biopsy, resulting in 2 cases of a proliferative endometrium and 1 case each of simple hyperplasia, hyperplasia with atypia, and scant tissue. No cases of hyperplasia were present in the patients with a homogeneous endometrium.
A heterogeneous cystic endometrium is associated with the prolonged proliferative phase from chronic anovulation as well as endometrial hyperplasia.
本研究旨在评估伴有多囊卵巢综合征病史或卵巢表现的厚的、呈囊性的子宫内膜的发生率及意义。
一项经机构审查委员会批准的回顾性病历审查，对1998年1月1日至2005年12月31日的超声检查研究进行分析，发现245例具有临床特征、卵巢特征性超声表现、激素异常或多囊卵巢综合征病史的患者。获取了子宫内膜的超声厚度和表现（均匀或不均匀）以及活检的组织学结果。
227例患者的子宫内膜均匀，厚度在1至17毫米之间（平均±标准差，6.4±3.1毫米）；18例患者的子宫内膜不均匀，厚度在4至23毫米之间（平均，13.2±5.6毫米）。在18例子宫内膜不均匀的患者中，9例在子宫内膜内超声检查还发现微小囊性灶。其中，5例进行了子宫内膜活检，结果为2例增殖期子宫内膜，1例单纯性增生、1例非典型增生和1例组织稀少。子宫内膜均匀的患者中未出现增生病例。
不均匀的囊性子宫内膜与慢性无排卵导致的增殖期延长以及子宫内膜增生有关。
