Fischerova D, Culcasi C, Gatti E, Ng Z, Burgetova A, Szabó G
Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.
Ultrasound Obstet Gynecol. 2025 Jan;65(1):94-105. doi: 10.1002/uog.29122. Epub 2024 Nov 5.
A standardized methodology for the ultrasound evaluation of the pelvic sidewall has not been proposed to date. Herein, a collaborative group of gynecologists and gynecological oncologists with extensive ultrasound experience presents a systematic methodology for the ultrasonographic evaluation of structures within the pelvic sidewall. Five categories of anatomical structures are described (muscles, vessels, lymph nodes, nerves and ureters). A step-by-step transvaginal ultrasound (or, when this is not feasible, transrectal ultrasound) approach is outlined for the evaluation of each anatomical landmark within these categories. Accurate assessment of the pelvic sidewall using a standardized approach improves the detection and diagnosis of non-gynecological pathologies that may mimic gynecological tumors, reducing the risk of unnecessary and even harmful intervention. Furthermore, it plays an important role in completing the staging of malignant gynecological conditions. Transvaginal or transrectal ultrasound therefore represents a viable alternative to magnetic resonance imaging in the preoperative evaluation of lesions affecting the pelvic sidewall, if performed by an expert sonographer. A series of videoclips showing normal and abnormal findings within each respective category illustrates how establishing a universally applicable approach for evaluating this crucial region will be helpful for assessing both benign and malignant conditions affecting the pelvic sidewall. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
迄今为止，尚未提出用于盆腔侧壁超声评估的标准化方法。在此，一个由具有丰富超声经验的妇科医生和妇科肿瘤学家组成的协作小组提出了一种用于盆腔侧壁内结构超声评估的系统方法。描述了五类解剖结构（肌肉、血管、淋巴结、神经和输尿管）。概述了一种逐步经阴道超声（或者在不可行时，经直肠超声）方法，用于评估这些类别中的每个解剖标志。使用标准化方法准确评估盆腔侧壁可提高对可能模仿妇科肿瘤的非妇科病变的检测和诊断，降低不必要甚至有害干预的风险。此外，它在完成恶性妇科疾病的分期中起着重要作用。因此，如果由专业超声检查人员进行，经阴道或经直肠超声在影响盆腔侧壁病变的术前评估中是磁共振成像的可行替代方法。一系列显示每个类别中正常和异常发现的视频片段说明了建立一种普遍适用的评估这一关键区域的方法将如何有助于评估影响盆腔侧壁的良性和恶性疾病。© 2024作者。《妇产科超声》由约翰·威利父子有限公司代表国际妇产科超声学会出版。
