Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy.
Clinica di Radiologia EOC, Istituto Imaging della Svizzera Italiana (IIMSI), 6900 Lugano, Switzerland.
Int J Environ Res Public Health. 2022 May 11;19(10):5840. doi: 10.3390/ijerph19105840.
Uterine adenomyosis is a common benign condition defined by the presence of heterotopic endometrial glands and stroma within the myometrium. Adenomyosis is often related to infertility and other adverse pregnancy outcomes. Modern imaging techniques allow the non-invasive diagnosis of adenomyosis and, in this framework, Magnetic Resonance Imaging (MRI) has assumed a central role due to its high diagnostic accuracy in the detection of adenomyosis. Currently, there is still a lack of international consensus on adenomyosis diagnostic criteria and classification, despite the fact that an agreed reporting system would promote treatment outcomes and research. This review aims to emphasize the important contribution of MRI to the diagnosis of adenomyosis and to highlight how, thanks to the great tissue differentiation provided by MRI, it is possible to identify the main direct (cystic component) and indirect (junctional zone features) signs of adenomyosis and to distinguish its various subtypes according to different MRI-based classifications. We also explored the main MRI criteria to identify the most common pitfalls and differential diagnoses of adenomyosis, whose features should be considered to avoid misdiagnosis.
子宫腺肌病是一种常见的良性疾病，其特征是子宫内膜腺体和基质异位位于子宫肌层内。腺肌病常与不孕和其他不良妊娠结局有关。现代影像学技术可实现对腺肌病的非侵入性诊断，在此背景下，由于磁共振成像（MRI）在检测腺肌病方面具有较高的诊断准确性，因此它在其中发挥了核心作用。尽管有一个共识性的报告系统将有助于改善治疗结果和研究，但目前在腺肌病的诊断标准和分类方面仍缺乏国际共识。本综述旨在强调 MRI 在诊断腺肌病中的重要贡献，并强调如何借助 MRI 提供的出色组织分化能力，识别出腺肌病的主要直接（囊性成分）和间接（交界带特征）征象，并根据不同的基于 MRI 的分类方法对其各种亚型进行区分。我们还探讨了识别腺肌病最常见的陷阱和鉴别诊断的主要 MRI 标准，这些特征应加以考虑以避免误诊。
