Johnson W K, Ott D J, Chen M Y, Fayez J A, Gelfand D W
Department of Radiology, Bowman Gray School of Medicine, Winston-Salem, NC 27157-1088.
Abdom Imaging. 1994 May-Jun;19(3):278-80. doi: 10.1007/BF00203528.
Endometriosis is a common disease in young women being evaluated for infertility. Although endometriosis may cause tubal abnormalities on hysterosalpingography, efficacy of radiographic evaluation in this disease is not clear. We reviewed the radiographic and laparoscopic examinations in 50 women being studied for infertility. Laparoscopy was normal in 15 women and showed endometriosis in 35 patients. Endometriosis was staged at laparoscopy using the classification of the American Fertility Society. Radiographic examinations were reviewed blindly and tubal status noted in each patient. Criteria for tubal abnormality included incomplete or absent filling and ampullary dilatation or convolution. Radiographic efficacy was determined by correlating the tubal appearance to the severity and location of endometriosis. A total of 98 tubes were correlated but only 10 (10%) were felt to be involved by endometriosis based on laparoscopic findings. Radiologic sensitivity was 40% (4 of 10) and specificity was 83% (73 of 88). Positive predictive value was 21% (4 of 19) due to 15 false-positive diagnoses in tubes uninvolved by endometriosis. In conclusion, endometriosis, regardless of its severity, rarely causes radiographic abnormalities on hysterosalpingography because of the location of disease in the pelvis.
子宫内膜异位症是年轻女性不孕评估中常见的疾病。虽然子宫内膜异位症在子宫输卵管造影上可能导致输卵管异常，但放射学评估在该疾病中的效果尚不清楚。我们回顾了50名因不孕接受研究的女性的放射学和腹腔镜检查。15名女性腹腔镜检查正常，35名患者显示有子宫内膜异位症。在腹腔镜检查时根据美国生育协会的分类对子宫内膜异位症进行分期。对放射学检查进行盲法回顾，并记录每名患者的输卵管状况。输卵管异常的标准包括充盈不完全或无充盈以及壶腹部扩张或迂曲。通过将输卵管外观与子宫内膜异位症的严重程度和位置相关联来确定放射学效果。总共98条输卵管进行了关联，但根据腹腔镜检查结果，只有10条（10%）被认为有子宫内膜异位症累及。放射学敏感性为40%（10条中的4条），特异性为83%（88条中的73条）。由于在未受子宫内膜异位症累及的输卵管中有15例假阳性诊断，阳性预测值为21%（19条中的4条）。总之，由于盆腔内疾病的位置，无论严重程度如何，子宫内膜异位症在子宫输卵管造影上很少引起放射学异常。
