Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Biomed Res Int. 2017;2017:8967803. doi: 10.1155/2017/8967803. Epub 2017 Sep 18.
To determine the prevalence of ultrasound features suggestive of adenomyosis in women undergoing surgery for endometriosis compared with a control group of healthy women without endometriosis.
Retrospective case-control study comparing women with intractable pain or infertility, who underwent transvaginal ultrasound and subsequent laparoscopic surgery, with a control group of healthy women without a previous history of endometriosis. A diagnosis of adenomyosis on TVUS was made based on asymmetrical myometrial thickening, linear striations, myometrial cysts, hyperechoic islands, irregular endometrial-myometrial junction, parallel shadowing, and localized adenomyomas and analyzed for one sign and for three or more signs.
The study and control groups included 94 and 60 women, respectively. In the study group, women were younger and had more dysmenorrhea and infertility symptoms. The presence of any sonographic feature of adenomyosis, as well as three or more signs, was found to be more prevalent in the study group, which persisted after controlling for age, for all features but linear striations. Women in the study group who had five or more sonographic features of adenomyosis had more than a threefold risk of suffering from infertility (OR = 3.19, = 0.015, 95% CI; 1.25-8.17). There was no association with disease severity at surgery.
Sonographic features of adenomyosis are more prevalent in women undergoing surgery for endometriosis compared to healthy controls. Women with more than five features had an increased risk of infertility.
比较因子宫内膜异位症接受手术的女性与无子宫内膜异位症病史的健康对照组女性，以确定超声表现提示腺肌病的患病率。
这是一项回顾性病例对照研究，比较了因难治性疼痛或不孕接受经阴道超声和随后腹腔镜手术的女性与无先前子宫内膜异位症病史的健康对照组女性。TVUS 上腺肌病的诊断依据是不对称性子宫肌层增厚、线性条纹、子宫肌囊肿、高回声岛、不规则子宫内膜-子宫肌层交界、平行阴影和局灶性腺肌瘤，并分析了一个和三个或更多的征象。
研究组和对照组分别纳入 94 例和 60 例女性。在研究组中，女性更年轻，痛经和不孕症状更多。研究组中存在任何超声表现的腺肌病特征，以及三个或更多征象更为常见，且在控制年龄后，除线性条纹外，所有特征均如此。在研究组中，有 5 个或更多超声特征提示腺肌病的女性不孕的风险增加了三倍以上（OR=3.19，=0.015，95%CI；1.25-8.17）。与手术时的疾病严重程度无关。
与健康对照组相比，因子宫内膜异位症接受手术的女性中超声表现提示腺肌病更为常见。有 5 个以上特征的女性不孕风险增加。
