Guerriero Stefano, Alcázar Juan Luis, Ajossa Silvia, Pilloni Monica, Melis Gian Benedetto
Department of Obstetrics and Gynecology, University of Cagliari, Ospedale San Giovanni di Dio, Via Ospedale 46, 09124 Cagliari, Italy.
J Ultrasound Med. 2009 Aug;28(8):1061-6. doi: 10.7863/jum.2009.28.8.1061.
The purpose of this presentation is to investigate the potential role of 3-dimensional (3D) sonography in the assessment of deep endometriosis.
Cases of deep endometriosis are presented to illustrate the spectrum of appearances obtained with 3D sonography. In addition, we evaluate the possible role of other functions included in 3D equipment, such as the niche mode and tomographic ultrasound imaging (TUI).
Three-dimensional image rendering could allow a good analysis of the endometriotic nodule; in fact, in all presented cases, this reconstruction seems to clearly show the irregular shapes and borders of the lesions. This technique allows unrestricted access to an infinite number of viewing planes, which can be very useful for correctly locating lesions within the pelvis and evaluating the relationship with other organs. The stored 3D volumes can be reassessed and compared by the same or different examiners over time. This characteristic may be relevant for monitoring the effect of medical therapies over time. In the niche mode, sonographic imaging is represented as a "cut-open" view of the internal aspect of the nodule and its surrounding tissue. This additional function, which is associated with TUI, could be particularly useful for evaluation of the extension of a nodule in the rectovaginal septum, the depth of infiltration, and the relationship with the rectosigmoid junction or ureter.
In the near future, 3D sonography in deep infiltrating endometriosis could be an interesting mode of research with positive effects in everyday clinical practice.
本报告旨在探讨三维（3D）超声检查在深部子宫内膜异位症评估中的潜在作用。
展示深部子宫内膜异位症病例，以说明3D超声检查所获得的表现范围。此外，我们评估3D设备所具备的其他功能的可能作用，如壁龛模式和断层超声成像（TUI）。
三维图像重建能够对子宫内膜异位结节进行良好分析；事实上，在所有展示的病例中，这种重建似乎清晰显示了病变的不规则形状和边界。该技术允许不受限制地访问无数个观察平面，这对于在盆腔内正确定位病变以及评估与其他器官的关系非常有用。存储的3D容积可由同一或不同检查者在不同时间重新评估和比较。这一特性对于长期监测药物治疗效果可能具有重要意义。在壁龛模式下，超声成像呈现为结节内部及其周围组织的“切开”视图。这种与TUI相关的附加功能对于评估结节在直肠阴道隔中的延伸、浸润深度以及与直肠乙状结肠交界处或输尿管的关系可能特别有用。
在不久的将来，3D超声检查在深部浸润性子宫内膜异位症中可能成为一种有趣的研究方式，并在日常临床实践中产生积极影响。
