Rizzello Francesca, Capezzuoli Tommaso, D'Amato Scherbatoff Ippolita, Cozzolino Mauro, Gandini Loredana, Coccia Maria Elisabetta
Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy.
Department of Experimental Medicine, Section of Medical Physiopathology, University of Rome La Sapienza, Rome, Italy.
J Ultrasound Med. 2017 Nov;36(11):2271-2278. doi: 10.1002/jum.14258. Epub 2017 May 27.
The objective of the study was to evaluate the correlation between endometrioma-associated pain and lesion vascularization as measured with 3-dimensional power Doppler transvaginal sonography.
Endometriomas were examined, and 4 indices were obtained: mean grayness, flow index, vascularization index, and vascularization-flow index. Dysmenorrhea, chronic pelvic pain, and dyspareunia were analyzed in terms of severity, presence/absence, and duration.
Twenty-nine women were selected. The univariable association of painful symptoms in terms of presence/absence and duration was low with the exception of mean grayness with the presence of chronic pelvic pain (β = -0.106; P = .047; 95% confidence interval, 0.810 to 0.998). The R value increased to 0.226 for dysmenorrhea (β = -0.475; P = .029) when analyzing the association between the vascularization index and the severity of painful symptoms. The visual analog scale scores for chronic pelvic pain and dyspareunia were higher (R = 0.300; β = -0.547 and -0.548, respectively; P = .028 and .053).
We observed an inverse association between the severity of pain and endometrioma vascularization. Further larger studies are required to confirm our findings.
本研究的目的是评估三维能量多普勒经阴道超声测量的卵巢巧克力囊肿相关疼痛与病变血管化之间的相关性。
对卵巢巧克力囊肿进行检查，获得4个指标：平均灰度、血流指数、血管化指数和血管化血流指数。对痛经、慢性盆腔疼痛和性交困难的严重程度、有无及持续时间进行分析。
选取29名女性。除平均灰度与慢性盆腔疼痛的存在之间存在关联外（β=-0.106；P=0.047；95%置信区间，0.810至0.998），疼痛症状在有无及持续时间方面的单变量关联较低。在分析血管化指数与疼痛症状严重程度之间的关联时，痛经的R值增至0.226（β=-0.475；P=0.029）。慢性盆腔疼痛和性交困难的视觉模拟评分较高（R分别为0.300；β分别为-0.547和-0.548；P=0.028和0.053）。
我们观察到疼痛严重程度与卵巢巧克力囊肿血管化之间存在负相关。需要进一步开展更大规模的研究来证实我们的发现。
