Kunz G, Herbertz M, Beil D, Huppert P, Leyendecker G
Department of Obstetrics and Gynaecology, St. Johannes Hospital, Dortmund, Germany.
Reprod Biomed Online. 2007 Dec;15(6):681-5. doi: 10.1016/s1472-6483(10)60535-4.
Magnetic resonance imaging (MRI) allows the diagnosis of adenomyosis in vivo with a high sensitivity and specificity. Usually the diagnosis of adenomyosis is obtained from women in their fourth to fifth decade of life. However, recent data suggest that adenomyosis may develop much sooner in life, particularly in women with endometriosis. In order to test these suggestions, MRI of the uterus in 227 women with and without endometriosis was performed and the results were related to the age of the subjects (age groups: 17-24, 25-29, 30-34 and >34 years). The study revealed that the process of the development of adenomyosis, represented by an increased diameter of the dorsal junctional zone of the uterus as the imaging correlative of the invasion of basal endometrium into the junctional zone, had already commenced early in the third decade of life and progressed steadily during the fourth decade in women with endometriosis. Women without endometriosis showed almost no signs of adenomyosis up to the age of 34 years. Surprisingly, parallel in both groups of women, a marked increase in the incidence of adenomyosis could be observed beyond the age of 34 years, thus representing a common phenomenon in the age-related pathophysiological continuum of adenomyosis.
磁共振成像（MRI）能够在体内以高灵敏度和特异性诊断子宫腺肌病。通常子宫腺肌病的诊断多见于处于40至50岁年龄段的女性。然而，近期数据表明子宫腺肌病可能在生命中更早出现，尤其是在患有子宫内膜异位症的女性中。为了验证这些观点，对227名患有和未患有子宫内膜异位症的女性进行了子宫MRI检查，并将结果与受试者年龄（年龄组：17 - 24岁、25 - 29岁、30 - 34岁和>34岁）相关联。研究表明，子宫腺肌病的发展过程，以子宫背侧交界区直径增加为代表，作为基底子宫内膜侵入交界区的影像学关联指标，在生命第三个十年早期就已开始，并在患有子宫内膜异位症的女性的第四个十年中稳步进展。在34岁之前，未患有子宫内膜异位症的女性几乎没有子宫腺肌病的迹象。令人惊讶的是，在两组女性中，34岁以后子宫腺肌病的发病率均显著增加，因此这代表了子宫腺肌病与年龄相关的病理生理连续过程中的一种常见现象。
