Mathieu Svea-Vivica, Kobe Adrian, Pfammatter Thomas, Hötker Andreas
Institut für Diagnostische und Interventionelle Radiologie, Universitätsspital Zürich.
Ther Umsch. 2020;77(2):57-61. doi: 10.1024/0040-5930/a001153.
Endometriosis Endometriosis, which is the presence of functional endometrial tissue outside the endometrium, represents one of the most common gynecological diseases. Given the variability of the symptoms depending on the exact localization of the disease, it is not uncommon for a patient to be diagnosed only after approximately 10 years of suffering. Localizations of the disease can include the typical endometrioma of the ovaries and in particular the lesser pelvis (e. g., fallopian tubes, uterine ligaments). It is then termed "deep pelvic endometriosis" and may be the reason for scarring, chronic pelvic pain and infertility. MRI has become increasingly popular in assessing the extent of the disease, due to its increasing availability and excellent soft tissue contrast. Recently, European guidelines have been published to better standardize technical MRI parameters and reporting, in addition to several scoring systems (e. g., the ENZIAN score), which have been established in the past. This allows for a precise localization of the disease and may guide surgical management in advanced cases. Other therapeutic options - depending on the severity of the symptoms - include pain medication or hormonal treatments. In the case of adenomyosis, the embolization of the uterine arteries as a minimally invasive approach has demonstrated excellent results.
子宫内膜异位症 子宫内膜异位症是指子宫内膜功能组织出现在子宫内膜以外的部位，是最常见的妇科疾病之一。鉴于症状因疾病的确切位置而异，患者在患病约10年后才被诊断出来并不罕见。该疾病的位置可包括典型的卵巢子宫内膜异位囊肿，尤其是盆腔下部（如输卵管、子宫韧带）。然后将其称为“深部盆腔子宫内膜异位症”，这可能是瘢痕形成、慢性盆腔疼痛和不孕的原因。由于MRI的可及性不断提高且软组织对比度极佳，其在评估疾病范围方面越来越受欢迎。最近，除了过去已经建立的几种评分系统（如ENZIAN评分）外，还发布了欧洲指南，以更好地规范MRI技术参数和报告。这有助于精确确定疾病位置，并可能指导晚期病例的手术管理。其他治疗选择——取决于症状的严重程度——包括止痛药或激素治疗。对于子宫腺肌病，子宫动脉栓塞作为一种微创方法已显示出优异的效果。
