Zhang Michelle, Bazot Marc, Tsatoumas Maria, Munro Malcolm G, Reinhold Caroline
Department of Radiology, 54473McGill University Health Centre, Montreal, QC, Canada.
Montreal Imaging Experts Inc, Montreal, QC, Canada.
Can Assoc Radiol J. 2023 Feb;74(1):58-68. doi: 10.1177/08465371221114197. Epub 2022 Jul 20.
The purpose of this review is to (i) summarize the current literature regarding the role of magnetic resonance imaging (MRI) in diagnosing adenomyosis, (ii) examine how to integrate MRI phenotypes with clinical symptomatology and histological findings, (iii) review recent advances including proposed MRI classifications, (iv) discuss challenges and pitfalls of diagnosing adenomyosis, and (v) outline the future role of MRI in promoting a better understanding of the pathogenesis, diagnosis, and treatment options for patients with uterine adenomyosis. Recent advances and the widespread use of MRI have provided new insights into adenomyosis and the range of imaging phenotypes encountered in this disorder. Direct and indirect MRI features allow for accurate non-invasive diagnosis of adenomyosis. Adenomyosis is a complex and poorly understood disorder with variable MRI phenotypes that may be correlated with different pathogeneses, clinical presentations, and patient outcomes. MRI is useful for the assessment of the extent of findings, to evaluate for concomitant gynecological conditions, and potentially can help with the selection and implementation of therapeutic options. Nevertheless, important gaps in knowledge remain. This is in part due to the lack of standardized criteria for reporting resulting in heterogeneous and conflicting data in the literature. Thus, there is an urgent need for a unified MRI reporting system incorporating standardized terminology for diagnosing adenomyosis and defining the various phenotypes.
（i）总结当前关于磁共振成像（MRI）在诊断子宫腺肌病中作用的文献；（ii）研究如何将MRI表型与临床症状及组织学发现相结合；（iii）回顾包括MRI分类建议在内的最新进展；（iv）讨论子宫腺肌病诊断中的挑战与陷阱；（v）概述MRI在促进更好地理解子宫腺肌病患者的发病机制、诊断及治疗选择方面的未来作用。MRI的最新进展及其广泛应用为子宫腺肌病及该疾病中遇到的一系列成像表型提供了新的见解。MRI的直接和间接特征有助于准确无创地诊断子宫腺肌病。子宫腺肌病是一种复杂且了解不足的疾病，具有可变的MRI表型，这些表型可能与不同的发病机制、临床表现及患者预后相关。MRI有助于评估病变范围、评估合并的妇科疾病，并且可能有助于治疗方案的选择与实施。然而，知识方面仍存在重要空白。部分原因是缺乏报告的标准化标准，导致文献中的数据存在异质性且相互矛盾。因此，迫切需要一个统一的MRI报告系统，纳入用于诊断子宫腺肌病和定义各种表型的标准化术语。
