Department of Diagnostic Imaging, Fleury Medicina e Saúde, Rua Cincinato Braga, São Paulo, Brazil.
Radiographics. 2010 Sep;30(5):1235-49. doi: 10.1148/rg.305095221.
Deeply infiltrating endometriosis (DIE) is a common gynecologic disease that is characterized by a difficult and delayed diagnosis. Radiologic mapping of the DIE lesion sites is crucial for case management, patient counseling, and surgical planning. Transvaginal ultrasonography (US) is the initial imaging modality for investigating DIE and has been the focus of several recent studies. DIE typically manifests at imaging as hypoechogenic nodules throughout the affected sites and thickening of the intestinal wall, with some lesions showing a mixed pattern due to cystic areas. Transvaginal US performed after bowel preparation improves the ability to diagnose intestinal lesions and provides invaluable details, including which layers of the intestine are affected and the distance between the lesion and the anal border. It is vital that radiologists be familiar with the technical aspects of this modality and with the US manifestations of DIE lesions. Transvaginal US performed after bowel preparation should be the first-line imaging modality for the evaluation of women with suspected endometriosis.
深部浸润型子宫内膜异位症（DIE）是一种常见的妇科疾病，其特点是诊断困难且延误。DIE 病变部位的放射学定位对于病例管理、患者咨询和手术计划至关重要。经阴道超声（US）是 DIE 的初始影像学检查方法，也是最近几项研究的重点。DIE 在影像学上的表现通常为受累部位的低回声结节和肠壁增厚，一些病变由于囊腔而呈现混合模式。肠道准备后的经阴道 US 可提高诊断肠病变的能力，并提供有价值的细节，包括肠的哪一层受到影响以及病变与肛门边缘之间的距离。放射科医生熟悉这种方式的技术方面以及 DIE 病变的 US 表现至关重要。肠道准备后的经阴道 US 应该是评估疑似子宫内膜异位症女性的一线影像学检查方法。
