子宫腺肌病合并不孕的研究进展

子宫腺肌病是妇产科常见的一种良性疾病,其主要临床表现为继发痛经,经量增多,性交痛及女性不孕.随着女性的首次生育年龄推迟至30～40岁,在不孕症门诊中子宫腺肌病的发病率明显提高,研究显示不孕症患者中子宫腺肌病的发生率为6.9％ ～34.3％.目前临床上诊断子宫腺肌病合并不孕女性的治疗目前尚无统一的治疗方案.本文作者拟结合...     

子宫腺肌病发病的相关因素研究进展

子宫腺肌病常好发于育龄女性,主要表现是经量显著增多、经期明显延长,并出现渐进性的痛经。其诊断的主要依据是根据患者的症状、妇科相关检查、B超,血清检测CA125常具有协助诊断的意义。相关发病机制尚不清楚,可能和子宫内膜的损伤、显著升高的雌激素血症,以及免疫因素相关。本文就近年以来,子宫腺肌病的发病相关因素方面的研究做一综述(包括血管生成因素、免疫因素、子宫内膜损伤或炎症等方面),为子宫腺肌病发病的预防、临床诊断、治疗及预后提供一定参考。     

子宫腺肌病与子宫肌瘤临床对比分析

当子宫内膜侵入子宫肌层时,称之为子宫腺肌病[1],以往曾将其称为内在性子宫内膜异位症。近年来发现它与外在性子宫内膜异位在组织发生学等方面有许多不同之处,因此被划分为一种独立的子宫疾病。腺肌病在基层医院临床术前诊断中常常误诊为子宫肌瘤。为提高子宫腺肌病临床术前诊断率,我们将其与子宫肌瘤从临床表现进行对比分析。1资料与方法选择1995年1月一1998年12月我院子宫切除术后标本经病理确诊为子宫腺肌病患者22例为腺肌病组。随机抽取同期于它切除术后病理确诊为子宫肌瘤患者22例（不包括腺肌病合并子宫肌瘤及内膜异位症患者）为…     

96例子宫腺肌病B超声像分析

目的 探讨子宫腺肌病B超声像特点及超声检查的临床应用价值。方法 回顾性分析96例经手术和病理证实为子宫腺肌病的B超声像特点，并与手术对照。结果 96例子宫腺肌病B超声像特点为子宫增大、形态改变、子宫肌层厚度不均、内膜线偏移和宫肌层回声异常。超声所见肌层异常回声部位与手术所见病灶部位基本一致。结论超声检查可为子宫腺肌病的诊断提供重要的参考信息。结合 B超声像特点和临床病史，有利于提高子宫腺肌病诊断的准确率，且有利于鉴别诊断。     

子宫腺肌病的超声诊断及声像图分析

目的 探讨子宫腺肌病的声像图特征,提高超声诊断的准确性.方法 对42例被临床及病理证实为子宫腺肌病的声像图表现进行回顾性分析并分类.结果 42例患者术前超声诊断与术后病理结果对照,超声诊断子宫腺肌病的符合率为92.9%(39/42),误诊1例,漏诊2例.本组子宫腺肌病的声像图特征可归纳为弥漫型、前壁型、后壁型、局限型和混合型5型.结论 超声诊断子宫腺肌病有较高的准确性且具有无创、安全、可重复检查等优点,对子宫腺肌病的诊断和鉴别诊断具有重要的临床应用价值.     

超声检查对子宫肌腺病的诊断价值及误诊分析

目的探讨超声对子宫肌腺病的诊断价值及误诊原因的分析。方法通过对88例患者进行术前超声检查,并与术后病理结果对比分析。结果子宫肌腺病声像图可分为弥漫型、局灶型。与病理结果比较,超声诊断子宫肌腺病诊断正确率88.6%,误诊率8.0%,漏诊率3.4%。结论超声对子宫肌腺病诊断及鉴别诊断均有较重要的临床价值。     

子宫腺肌病的超声诊断及分析

目的:探讨子宫腺肌病的声像图特征,为临床诊治提供依据。方法:对术前超声诊断的154例子宫腺肌病的声像图特征、临床特点与术后病理对照进行综合性分析。结果:仔细观察子宫的大小、形态、宫壁病灶内部图像,超声诊断准确率为81.8％。结论:进一步提高子宫腺肌病的诊断与鉴别诊断价值。     

血清CA125测定及超声检查诊断子宫腺肌病的临床分析

作通过对比子宫腺肌病与子宫肌瘤患血清CA125测定及B超检查，探讨诊断子宫腺肌病的临床诊断价值。     

CA125和 EMAb 联合检测在腺肌病与子宫肌瘤中的临床意义分析

子宫腺肌病的发病率目前有逐渐升高趋势,子宫腺肌病是子宫腺体以及间质侵入子宫肌肉,从而产生了局限性或者弥漫性病变,是常见的妇科疾病,患者可出现继续发性痛经、月经量增加等,严重影响到患者的身心健康。子宫腺肌病与子宫肌瘤的临床症状有相似地方,给临床正确诊断带来影响［1,2］。血清糖类抗原（CA125）和抗子宫内膜抗体（EMAb）在子宫腺肌病和子宫肌瘤患者体内水平均有改变,本文观察上述因子水平改变情况对子宫腺肌病和子宫肌瘤的鉴别诊断意义。     

子宫腺肌病超声误诊11例分析

子宫腺肌病与子宫肌瘤在临床及超声诊断方面均有很多相似之处。故常将子宫腺肌病误诊为子宫肌瘤。现将我室B超误诊的11例子宫腺肌病声象图作一回顾性分析。 自1983年1月至1987年11月B超诊断为子宫     

子宫腺肌病与子宫肌瘤的临床对比分析

目的探讨子宫腺肌病与子宫肌瘤的临床区别 ,以提高术前诊断率。方法选择 42例子宫腺肌病患者和 5 7例子宫肌瘤患者为研究对象 ,并对发病年龄、临床表现、B超结果及血清CA12 5、CA199水平进行比较。结果两组患者发病年龄及临床表现相近 ,但子宫腺肌病痛经症状明显 (P <0 0 1) ,B超有特征性改变 ,血清CA12 5水平明显升高 ,阳性率为 78 5 7% ,显著高于子宫肌瘤 (阳性率为 5 2 6% ) (P <0 0 5 ) ,而两组CA199水平无统计学意义 (P >0 0 5 )。结论鉴别子宫腺肌病和子宫肌瘤主要依靠临床表现及B超所见 ,测定血清CA12 5水平对鉴别诊断有一定参考价值。     

Intrauterine cystic adenomyosis:Report of two cases

BACKGROUND Cystic adenomyosis is a special type of adenomyosis. Its clinical manifestations lack specificity. Pelvic ultrasound and nuclear magnetic resonance imaging can help clarify the diagnosis. Because cystic uterine adenomyosis is rare in clinical work, it can be easily misdiagnosed or its diagnosis can be missed. Early surgical treatment and postoperative drug treatment can alleviate dysmenorrhea,menorrhagia, anemia, and other symptoms.CASE SUMMARY Two cases complained about abnormal vaginal bleeding and were diagnosed with intrauterine cystic adenomyosis by gynecological ultrasound and pathological examination. The clinical manifestations included dysmenorrhea,hypermenorrhea, and a history of cesarean section. Both cases underwent a surgery, and chocolate-like liquid was released from the cystic mass in the uterus and the manifestations were relieved.CONCLUSION Intrauterine cystic adenomyosis could be diagnosed by pathological examination and treated by hysterectomy or hystscopy to release the liquid inside.     

Benign myometrial conditions: leiomyomas and adenomyosis

Leiomyomas and adenomyosis are common benign myometrial conditions. Although their symptoms overlap, traditional treatment of these two entities differs; thus, making the correct diagnosis is critical. Specifically, uterine-conserving therapy is well established for many women with symptomatic leiomyomas, whereas hysterectomy is the treatment for debilitating adenomyosis. Magnetic resonance imaging (MRI) is the most accurate modality for identifying leiomyomas and adenomyosis. T2-weighted sequences often are diagnostic. For leiomyomas, MRI reliably identifies their number, size, and location. These features help triage patients to appropriate therapy. For adenomyosis, MRI establishes the diagnosis in cases of equivocal or nondiagnostic ultrasounds. MRI also has been used to confirm an ultrasound diagnosis of adenomyosis when curative surgery is being considered. Intravenous gadolinium chelates are not necessary to make the diagnosis of either adenomyosis or leiomyomas, but it provides useful information about vascularity of lesions, a factor that may impact the type of treatment undertaken.     

Decidualized adenomyosis during pregnancy and post delivery: three cases of magnetic resonance imaging findings

Adenomyosis is a common gynecologic disease. Pregnancy with adenomyosis is on the increase due to a tendency of delay with first pregnancies and various infertility treatments involved in the process. We encountered decidualized adenomyosis in three patients during pregnancy, who were suspected by magnetic resonance (MR) imaging and were followed monitored post delivery. The MR imaging findings of adenomyosis during pregnancy showed low signal intensity areas with embedded bright foci that expanded to a few mm in diameter on half Fourier single-shot turbo spin-echo images. This finding may reflect decidual change of the stroma within the ectopic endometrium caused during pregnancy. The MR imaging findings of adenomyosis after childbirth showed hemorrhage inside the lesion, which were assumed to be led by rapid decrease in a blood flow to adenomyosis post childbirth.     

MRI用于子宫腺肌病和子宫月肌瘤鉴别诊断的临床研究

目的:了解子宫腺肌病、子宫肌瘤的MRI影像学表现及特征性征像,以进一步提高MRI对两者鉴别诊断的临床指导价值。方法:回顾性分析经手术病理证实的子宫腺肌病、子宫肌瘤各40例病例的MRI影像学表现,并对各种常见征像进行统计学分析。结果:子宫腺肌病和子宫肌瘤在病灶数目、部位、分布等征像差异均有统计学意义(P<0.05)。结论:病变中有5个观察指标最能提示为子宫肌瘤,其中前3个征像为子宫肌瘤特有征象。MRI对子宫腺肌病和子宫肌瘤的临床鉴别诊断具有重要指导价值。     

螺旋CT诊断子宫腺肌症临床应用

目的探讨螺旋CT诊断子宫腺肌症的临床价值。方法收集经CT诊断并经手术和病理证实的32例子宫腺肌症进行回顾性分析。结果本组病例子宫体积不同程度增大,30/32例子宫体积明显增大,2/32例轻度增大。平扫:3/32例可见子宫壁散在性出血点。增强扫描30/32例子宫壁显示多发低密度内伴斑点状高密度内膜异位强化,2/32例子宫壁显示单纯散在小点状内膜异位强化。10/32例子宫腺肌症伴有卵巢巧克力囊肿。结论典型的子宫腺肌症显示子宫壁多发低密度内伴高密度内膜异位强化为其特征。     

子宫动脉栓塞术治疗子宫腺肌病的疗效分析

目的探讨子宫动脉栓塞术治疗子宫腺肌病的临床疗效。方法2008年1月至2010年1月采用子宫动脉栓塞术治疗的子宫腺肌病患者69例,采用子宫动脉栓塞术治疗并观察临床疗效。结果69例患者138条子宫动脉全部插管顺利,顺利完成手术,成功率100％。临床疗效：69例子宫腺肌病患者中45例术后痛经完全缓解,21例明显缓解,3例复发。结论经导管子宫动脉栓塞术治疗子宫腺肌病,临床效果确切、具有创伤小,恢复快,无需切除子宫,近期疗效可靠,并发症少,住院时间短,保留生殖潜能等优点,为治疗子宫腺肌病提供了一种新的微创治疗方法。     

A systematic review with meta-analysis: the common sonographic characteristics of adenomyosis

Adenomyosis is a common debilitating gynaecological disease. Transvaginal sonography (TVS) has been shown to be capable of diagnosing adenomyosis with an acceptable degree of accuracy. However, the reported appearances of adenomyosis on TVS are numerous and there is no consensus in the literature as to which image characteristics are unequivocally diagnostic; clarification would assist the sonographer in confidently providing a diagnosis. Following a thorough search of the electronic databases Embase and Medline, nine articles assessing the diagnostic accuracy of the sonographic features of adenomyosis on TVS against a gold standard reference test (histology post hysterectomy), using sensitivity and specificity, were selected for inclusion. The methodological quality of each of the nine included articles was assessed using a valid and reliable checklist tool. Four articles were considered suitable for inclusion in meta-analysis, which was facilitated by Meta-DiSc (Clinical Biostatistics Unit, Ramón y Cajal Hospital, Madrid, Spain). Meta-analysis showed that the heterogeneity between the studies was too great to allow statistical pooling of data. There was a wide between-study variation in the proficiency of six well-documented ultrasound characteristics of adenomyosis to correctly identify the disease, despite an apparent similarity in the studies’ populations, interventions and outcomes. This systematic review has been unable to draw a concise conclusion about which ultrasound image characteristics are most reliable in the correct diagnosis of adenomyosis. Further research is required into the sonographic features of adenomyosis with much larger study groups to attempt to establish those features that could enhance the reliability of ultrasound image interpretation.     

经阴道与经腹超声对诊断子宫腺肌病的对比分析

目的:探讨超声诊断子宫腺肌病的价值。方法:对手术后病理证实的子宫腺肌病75例患者经腹或经阴道检查的诊断准确率进行对比分析。结果:经阴道超声检查符合率为80%,经腹超声检查诊断符合率为31%。结论:经阴道超声检查诊断子宫腺肌病的符合率明显高于经腹部超声检查。