子宫腺肌病的超声与MRI诊断及进展

doi:10.6040/j.issn.1671-7554.0.2022.0214

摘要/Abstract

摘要： 随着成像技术的进步,超声和MRI在评估子宫腺肌病中的作用愈来愈被临床认可。经阴道超声(TVUS)是诊断子宫腺肌病的一线诊断工具,MRI有更多的补充作用。论文从子宫腺肌病的影像病理学基础、子宫腺肌病分型、子宫腺肌病超声特征和规范化描述、超声新技术进展及MRI的分类评价等几方面进行阐述。

关键词: 子宫腺肌病, 超声, 磁共振成像, 超声造影, 弹性成像

Abstract: With the development of medical imaging technology, the role of ultrasound and magnetic resonance imaging(MRI)in the evaluation of adenomyosis has been increasingly recognized in clinical work. Transvaginal ultrasound(TVUS)remains the first-line diagnostic method for adenomyosis and MRI can serve as a complementary tool. The purpose of this study is to review the imaging-pathological correlation, classification, ultrasonic and MRI features, standardized description of adenomyosis, advances in ultrasound techniques, and classification evaluation of MRI.

Key words: Adenomyosis, Ultrasound, Magnetic resonance imaging, Contrast-enhanced ultrasound, Elastography

中图分类号:

R711.74

陶国伟,王芳,董向毅,徐亚瑄,赵琳丽,胡蓓蓓. 子宫腺肌病的超声与MRI诊断及进展[J]. 山东大学学报 (医学版), 2022, 60(7): 56-65.

TAO Guowei, WANG Fang, DONG Xiangyi, XU Yaxuan, ZHAO Linli, HU Beibei. Diagnosis of adenomyosis using ultrasound and magnetic resonance imaging[J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 56-65.

参考文献

[1] Chapron C, Vannuccini S, Santulli P, et al. Diagnosing adenomyosis: an integrated clinical and imaging approach[J]. Hum Reprod Update, 2020, 26(3): 392-411.
[2] Oliva E, Zaloudek CJ, Soslow RA. Mesenchymal tumors of the uterus. In: Kurman RJ, Ellenson LH, Ronnett BM(eds). Blausteins pathology of the female genital tract(Sixth Edition)[M]. New York: Springer Science, 2011: 453-528.
[3] Ferenczy A. Pathophysiology of adenomyosis [J]. Hum Reprod Update, 1998, 4(4): 312-322.
[4] Bazot M, Cortez A, Darai E, et al. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology[J]. Hum Reprod, 2001, 16(11): 2427-2433.
[5] Pistofidis G, Makrakis E, Koukoura O, et al. Distinct types of uterine adenomyosis based on laparoscopic and histopathologic criteria[J]. Clin Exp Obstet Gynecol, 2014, 41(2): 113-118.
[6] Brosens I, Gordts S, Habiba M, et al. Uterine cystic adenomyosis: a disease of younger women[J]. J Pediatr Adolesc Gynecol, 2015, 28(6): 420-426.
[7] Benagiano G, Brosens I. History of adenomyosis[J]. Best Pract Res Clin Obstet Gynaecol, 2006, 20(4): 449-463.
[8] Chapron C, Tosti C, Marcellin L, et al. Relationship between the magnetic resonance imaging appearance of adenomyosis and endometriosis phenotypes[J]. Hum Reprod, 2017, 32(7): 1393-1401.
[9] Uduwela AS, Perera MA, Aiqing L, et al. Endometrial-myometrial interface: relationship to adenomyosis and changes in pregnancy[J]. Obstet Gynecol Surv, 2000, 55(6): 390-400.
[10] Hricak H, Alpers C, Crooks LE, et al. Magnetic resonance imaging of the female pelvis: initial experience[J]. AJR Am J Roentgenol, 1983, 141(6): 1119-1128.
[11] Vercellini P, Viganò P, Somigliana E, et al. Adenomyosis: epidemiological factors[J]. Best Pract Res Clin Obstet Gynaecol, 2006, 20(4): 465-477.
[12] Brown HK, Stoll BS, Nicosia SV, et al. Uterine junctional zone: correlation between histologic findings and MR imaging[J]. Radiology, 1991, 179(2): 409-413.
[13] Scoutt LM, Flynn SD, Luthringer DJ, et al. Junctional zone of the uterus: correlation of MR imaging and histologic examination of hysterectomy specimens[J]. Radiology, 1991, 179(2): 403-407.
[14] Novellas S, Chassang M, Delotte J, et al. MRI characteristics of the uterine junctional zone: from normal to the diagnosis of adenomyosis[J]. AJR Am J Roentgenol, 2011, 196(5): 1206-1213.
[15] Rasmussen CK, Glavind J, Madsen LD, et al. Repeatability of junctional zone measurements using 3-dimensional transvaginal sonography in healthy fertile women[J]. J Ultrasound Med, 2016, 35(7): 1497-1508.
[16] Parrott E, Butterworth M, Green A, et al. Adenomyosis—a result of disordered stromal differentiation[J]. Am J Pathol, 2001, 159(2): 623-630.
[17] Bergeron C, Amant F, Ferenczy A. Pathology and physiopathology of adenomyosis[J]. Best Pract Res Clin Obstet Gynaecol, 2006, 20(4): 511-521.
[18] Exacoustos C, Brienza L, Di Giovanni A, et al. Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology[J]. Ultrasound Obstet Gynecol, 2011, 37(4): 471-479.
[19] Hamimi A. What are the most reliable signs for the radiologic diagnosis of uterine adenomyosis? An ultrasound and MRI prospective[J]. Egypt J Radiol Nucl Med, 2015, 46(4): 1349-1355.
[20] Sofic A, Husic-Selimovic A, Carovac A, et al. The significance of MRI evaluation of the uterine junctional zone in the early diagnosis of adenomyosis[J]. Acta Inform Med, 2016, 24(2): 103-106.
[21] Rasmussen CK, Hansen ES, Dueholm M. Two- and three-dimensional ultrasonographic features related to histopathology of the uterine endometrial-myometrial junctional zone[J]. Acta Obstet Gynecol Scand, 2019, 98(2): 205-214.
[22] Rasmussen CK, Hansen ES, Ernst E, et al. Two- and three-dimensional transvaginal ultrasonography for diagnosis of adenomyosis of the inner myometrium[J]. Reprod Biomed Online, 2019, 38(5): 750-760.
[23] Dueholm M, Lundorf E, Hansen ES, et al. Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis[J]. Fertil Steril, 2001, 76(3): 588-594.
[24] Luciano DE, Exacoustos C, Albrecht L, et al. Three-dimensional ultrasound in diagnosis of adenomyosis: histologic correlation with ultrasound targeted biopsies of the uterus[J]. J Minim Invasive Gynecol, 2013, 20(6): 803-810.
[25] Schindl M, Birner P, Obermair A, et al. Increased microvessel density in adenomyosis uteri[J]. Fertil Steril, 2001, 75(1): 131-135.
[26] Goteri G, Lucarini G, Montik N, et al. Expression of vascular endothelial growth factor(VEGF), hypoxia inducible factor-1alpha(HIF-1alpha), and microvessel density in endometrial tissue in women with adenomyosis[J]. Int J Gynecol Pathol, 2009, 28(2): 157-163.
[27] Tahlan A, Nanda A, Mohan H. Uterine adenomyoma: a clinicopathologic review of 26 cases and a review of the literature[J]. Int J Gynecol Pathol, 2006, 25(4): 361-365.
[28] Van den Bosch T, de Bruijn AM, de Leeuw RA, et al. Sonographic classification and reporting system for diagnosing adenomyosis[J]. Ultrasound Obstet Gynecol, 2019, 53(5): 576-582.
[29] 中国医师协会妇产科医师分会子宫内膜异位症专业委员会.子宫腺肌病诊治中国专家共识[J]. 中华妇产科杂志, 2020, 55(6): 376-383.
[30] Andres MP, Borrelli GM, Ribeiro J, et al. Transvaginal ultrasound for the diagnosis of adenomyosis: systematic review and Meta-analysis[J]. J Minim Invasive Gynecol, 2018, 25(2): 257-264.
[31] Reinhold C, Tafazoli F, Mehio A, et al. Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation[J]. Radiographics, 1999, 19 Spec No: S147-S160.
[32] Van den Bosch T, Dueholm M, Leone FP, et al. Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment(MUSA)group[J]. Ultrasound Obstet Gynecol, 2015, 46(3): 284-298.
[33] Di Donato N, Seracchioli R. How to evaluate adenomyosis in patients affected by endometriosis?[J]. Minim Invasive Surg, 2014, 2014: 507230. doi: 10.1155/2014/507230.
[34] Kepkep K, Tuncay YA, Göynümer G, et al. Transvaginal sonography in the diagnosis of adenomyosis: which findings are most accurate?[J]. Ultrasound Obstet Gynecol, 2007, 30(3): 341-345.
[35] Naftalin J, Hoo W, Nunes N, et al. Association between ultrasound features of adenomyosis and severity of menstrual pain[J]. Ultrasound Obstet Gynecol, 2016, 47(6): 779-783.
[36] Verma SK, Lev-Toaff AS, Baltarowich OH, et al. Adenomyosis: sonohysterography with MRI correlation[J]. AJR Am J Roentgenol, 2009, 192(4): 1112-1116.
[37] Cunningham RK, Horrow MM, Smith RJ, et al. Adenomyosis: a sonographic diagnosis[J]. Radiographics, 2018, 38(5): 1576-1589.
[38] Levy G, Dehaene A, Laurent N, et al. An update on adenomyosis[J]. Diagn Interv Imaging, 2013, 94(1): 3-25.
[39] Xu C, Tang Y, Zhao Y, et al. Use of contrast-enhanced ultrasound in evaluating the efficacy and application value of microwave ablation for adenomyosis[J]. J Cancer Res Ther, 2020, 16(2): 365-371.
[40] 卢峻, 佘志红, 熊奕,等. 子宫肌瘤与子宫腺肌症超声造影强化形式的临床应用[J]. 放射学实践, 2011, 26(8): 890-892. LU Jun, SHE Zhihong, XIONG Yi, et al. Value of contrast-enhanced ultrasound with SonoVue in differentiation between uterine leiomyoma and uterine adenomyosis[J]. Radiologic Practice, 2011, 26(8): 890-892.
[41] Stoelinga B, Juffermans L, Dooper A, et al. Contrast-enhanced ultrasound imaging of uterine disorders: a systematic review[J]. Ultrason Imaging, 2021, 43(5): 239-252.
[42] Stoelinga B, Hehenkamp WJ, Brölmann HA, et al. Real-time elastography for assessment of uterine disorders[J]. Ultrasound Obstet Gynecol, 2014, 43(2): 218-226.
[43] Frank ML, Schäfer SD, Möllers M, et al. Importance of transvaginal elastography in the diagnosis of uterine fibroids and adenomyosis[J]. Ultraschall Med, 2016, 37(4): 373-378.
[44] Stoelinga B, Hehenkamp W, Nieuwenhuis LL, et al. Accuracy and reproducibility of sonoelastography for the assessment of fibroids and adenomyosis, with magnetic resonance imaging as reference standard[J]. Ultrasound Med Biol, 2018, 44(8): 1654-1663.
[45] 刘庆. 实时超声弹性成像技术用于子宫肌瘤、子宫腺肌瘤的鉴别诊断[J]. 影像研究与医学应用, 2019, 3(4): 219-220.
[46] Acar S, Millar E, Mitkova M, et al. Value of ultrasound shear wave elastography in the diagnosis of adenomyosis[J]. Ultrasound, 2016, 24(4): 205-213.
[47] Liu X, Ding D, Ren Y, et al. Transvaginal elastosonography as an imaging technique for diagnosing adenomyosis[J]. Reprod Sci, 2018, 25(4): 498-514.
[48] Bazot M, Dara E. Role of transvaginal sonography and magnetic resonance imaging in the diagnosis of uterine adenomyosis[J]. Fertil Steril, 2018, 109(3): 389-397.
[49] Bazot M, Cortez A, Darai E, et al. Ultrasonography comparedwith magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology [J]. Hum Reprod, 2001, 16(11): 2427-2433.
[50] Hauth EA, Jaeger HJ, Libera H, et al. MR imaging of the uterus and cervix in healthy women: determination of normal values [J]. Eur Radiol, 2007, 17(3): 734-742.
[51] Gordts S, Grimbizis G, Campo R. Symptoms and classification of uterine adenomyosis, including the place of hysteroscopy in diagnosis [J]. Fertil Steril, 2018, 109(3): 380-388.
[52] Champaneria R, Abedin P, Daniels J, et al. Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy [J]. Acta Obstet Gynecol Scand, 2010, 89(11): 1374-1384.
[53] Kobayashi H, Matsubara S. A classification proposal for adenomyosis based on magnetic resonance imaging [J]. Gynecol Obstet Invest, 2020, 85(2): 118-126.
[54] Gordts S, Brosens JJ, Fusi L, et al. Uterine adenomyosis: a need for uniform terminology and consensus classification [J]. Reprod Biomed Online, 2008, 17(2): 244-248.
[55] Agostinho L, Cruz R, Osório F, et al. MRI for adenomyosis: a pictorial review [J]. Insights Imaging, 2017, 8(6): 549-556.
[56] Chapron C, Fauconnier A, Vieira M, et al. Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification [J]. Hum Reprod, 2003, 18(1): 157-161.
[57] Bazot M, Darai E, Hourani R, et al. Deep pelvice ndometriosis: MR imaging for diagnosis and prediction of extension of disease [J]. Radiology, 2004, 232(2): 379-389.
[58] Kunz G, Beil D, Huppert P, et al. Adenomyosis in endometriosis-prevalence and impact on fertility. Evidence from magnetic resonance imaging [J]. Hum Reprod, 2005, 20(8): 2309-2316.
[59] Naftalin J, Hoo W, Nunes N, et al. Association between ultrasound features of adenomyosis and severity of menstrual pain [J]. Ultrasound Obstet Gynecol, 2016, 47(6): 779-783.
[60] 戴晴,郑宇觐.子宫腺肌病的超声诊断及进展[J].中国实用妇科与产科杂志,2019, 35(5): 501-504. DAI Qing, ZHENG Yujin. Ultrasound diagnosis and progress of adenomyosis [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2019, 35(5): 501-504.

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