Department of Radiology, Division of Interventional Radiology, University of Alabama at Birmingham, Birmingham, Alabama.
Division of Interventional Radiology, Department of Radiology, Mayo Clinic Florida, Jacksonville, Florida.
J Vasc Interv Radiol. 2022 May;33(5):586-592. doi: 10.1016/j.jvir.2022.01.017.
Adenomyosis poses an important diagnostic and therapeutic challenge in women's health because of a variety of clinical/imaging presentations and frequent coexistence with other benign gynecologic conditions. In recent years, uterine artery embolization (UAE) for the treatment of adenomyosis has shown encouraging and favorable outcomes and long-term symptom improvement. To expand the current understanding of adenomyosis pathophysiology, imaging diagnostic criteria, and treatment outcomes, the Society of Interventional Radiology Foundation gathered a multidisciplinary Research Consensus Panel with experts from diverse backgrounds. The topics addressed were centered around the following: (i) the clinical presentation and imaging findings to diagnose adenomyosis; (ii) the currently available medical, interventional, and surgical treatment options; and (iii) existing literature for and experiences with UAE in symptomatic disease. The panel acknowledged that before the pursuit of a clinical trial, it would be necessary to first evaluate the imaging criteria for adenomyosis and correlate them with pathology and symptoms to establish a noninvasive imaging classification system. Second priority was given to the development of a quality of life questionnaire to assess patient outcomes following treatment. The third priority was the performance of a prospective clinical trial comparing UAE with medical therapy, which would help establish UAE in the treatment algorithm and societal guidelines for symptomatic adenomyosis.
腺肌病因其多种临床表现和影像学表现以及常与其他良性妇科疾病共存,对妇女健康构成了重要的诊断和治疗挑战。近年来,子宫动脉栓塞术(UAE)治疗腺肌病的疗效令人鼓舞且效果良好,并能长期改善症状。为了进一步了解腺肌病的病理生理学、影像学诊断标准和治疗结果,介入放射学基金会组织了一个多学科研究共识小组,成员包括来自不同背景的专家。讨论的主题集中在以下几个方面:(i)诊断腺肌病的临床表现和影像学发现;(ii)目前可用的医学、介入和手术治疗选择;(iii)有症状疾病中 UAE 的现有文献和经验。该小组承认,在进行临床试验之前,首先需要评估腺肌病的影像学标准,并将其与病理学和症状相关联,以建立一种非侵入性的影像学分类系统。其次是制定生活质量问卷,以评估治疗后的患者结果。第三是进行前瞻性临床试验,比较 UAE 与药物治疗,这将有助于在治疗算法和有症状腺肌病的社会指南中确立 UAE 的地位。