深部浸润型子宫内膜异位症的诊断研究新进展

摘要

Deep infiltrating endometriosis (DIE) is a special type of endometriosis (EMs), which specifically refers to the infiltration depth of ≥ 5 mm of EMs lesions, involving in different parts of the pelvic cavity, mainly located in the posterior pelvic cavity, such as the uterosacral ligament, rectovaginal septum, colorectum, etc. At present, there are many ways to diagnose DIE, such as medical history, gynecological examination, ultrasound, magnetic resonance imaging (MRI), laparoscopy combined with pathological examination, but due to the limitation of the operator and other reasons of lack of experience or technology, the majority of patients were clinically misdiagnosed or missed. At present, researchers have proposed improved methods for the low detection rate of DIE, such as 3D or 4D ultrasound, fusion imaging, 3D-MRI, mehrzeilen-spiral CT colon water expansion (msCT-c) technique, etc., may improve the diagnostic rate of DIE.%深部浸润型子宫内膜异位症(deep infiltrating endometriosis,DIE)是子宫内膜异位症(endometriosis,EMs)的一种特殊类型,其特指浸润深度≥5 mm的EMs病灶.其可累及盆腔不同部位,主要位于后盆腔,如宫骶韧带、直肠阴道隔和结直肠等.目前诊断DIE的方法有多种,如病史问诊、妇科检查、超声、磁共振成像(MRI)、腹腔镜探查结合病理检查,但由于操作者经验不足或技术的局限性等原因,临床上有多数患者被误诊或漏诊.目前研究者们针对DIE的检出率低提出了改良方法,如3D或4D超声、融合成像、3D-MRI、多层螺旋CT结肠水膨胀(msCT-c)技术等,可能提高DIE的诊断率.