Department of Diagnostic Imaging, Chamié Imagem da Mulher, Rua Casa do Ator, 1117, cj 72, São Paulo, São Paulo, 04546-004, Brazil.
Department of Diagnostic Imaging, Fleury Medicina e Saúde, São Paulo, São Paulo, Brazil.
Abdom Radiol (NY). 2020 Jun;45(6):1648-1658. doi: 10.1007/s00261-019-02322-7.
Endometriosis is a common benign gynecological condition defined as the presence of endometrial tissue located outside the uterus and frequently associated with chronic pelvic pain and infertility. It is a polymorphic disease that can be presented as superficial implants, endometriomas and deep lesions that infiltrate the peritoneal surface associated with fibrosis and inflammatory reaction. Diagnosis of deep endometriosis is difficult and delayed, frequently missed in a routine ultrasound. Transvaginal ultrasound is the first-line imaging modality to investigate endometriosis and when performed by an expert in female pelvic imaging can provide a reliable mapping of the affected sites. Bowel preparation can be used to improve the detection of bowel lesions as well as the other sites affected by eliminating artifacts. Surgery has been the mainstay to treat symptomatic endometriosis and preoperative imaging mapping is crucial for better results and to reduce residual disease. The goals of surgery include radical removal of all lesions and the restoration of normal pelvic anatomy. The author describes technical aspects and imaging interpretation of the transvaginal sonography to investigate deeply infiltrative endometriosis.
子宫内膜异位症是一种常见的良性妇科疾病，定义为子宫内膜组织位于子宫外，常伴有慢性盆腔痛和不孕。它是一种多态性疾病，可以表现为浅表种植、子宫内膜异位囊肿和深部浸润性病变，浸润腹膜表面并伴有纤维化和炎症反应。深部子宫内膜异位症的诊断困难且延迟，在常规超声检查中经常漏诊。经阴道超声是诊断子宫内膜异位症的首选影像学检查方法，由女性盆腔影像学专家进行检查可以提供受累部位的可靠定位。肠道准备可用于提高对肠病变以及其他受影响部位的检测，消除伪影。手术一直是治疗有症状的子宫内膜异位症的主要方法，术前影像学定位对于获得更好的结果和减少残留疾病至关重要。手术的目标包括彻底切除所有病变和恢复正常的盆腔解剖结构。作者描述了经阴道超声检查深部浸润性子宫内膜异位症的技术方面和影像学解读。
