Abdominal Wall Endometrioma: Ultrasonographic Features and Correlation with Clinical Findings

摘要

Background: The diagnosis of abdominal wall endometrioma (AWE) is often confused with other surgical conditions. Certain factors relating to knowledge of the clinical history of the disease make correct diagnosis and treatment difficult. Aims: To present the clinical findings and ultrasonographic (US) features of AWE with special emphasis on size-related features. Study Design: This study reviewed abdominal wall endometriomas during a 2-year period in the Radiology Department of Sifa University Hospital, Izmir. Methods: Eleven women (mean age 32.6 years) with 12 scar endometriomas (mean diameter 29.2 mm) were consecutively evaluated by US and Colour Doppler examination (CDUS) prior to surgery. Lesions were grouped into large (≥3 cm) and small nodules. Vascularisation was classified as location (central, peripheral and mixed) and severity (absent, moderately vascular and hypervascular). In each patient, the nature of pain (absent, cyclic: associated with menstruation and continuous), historical and clinical data were documented. Four patients underwent Magnetic Resonance Imaging and their findings were presented. Fisher's exact test, χ2 test for categorical data and the unpaired T-test for continuous variables were used for statistical analysis. Results: In all the women, US of the AWE showed the presence of a solid hypoechoic mass (less echogenic than the surrounding hyperechoic fat) within the abdominal wall. There was a significant correlation between AWE sizes with repeated caesareans and the mean time between the last operation and admission to hospital (p3cm) ve kü?ük lezyonlar olarak grupland?r?lm??t?r. Lezyon kanlanmas? lokalizasyonuna g?re (merkezi, ?evresel ve kar???k) ve ?iddetine g?re (kanlanma yok, orta derecede kanlanma g?steren, zengin kanlanma g?steren) grupland?r?lm??t?r. Her hastada a?r?n?n ?zellikleri (a?r? yok, adetle birlikte-siklik, devaml?) hastan?n ?yküsü ve klinik bulgular? kaydedilmi?tir. Manyetik Rezonans G?rüntülemeye (MRG) giren 4 hastan?n ise MRG bulgular? sunulmu?tur. ?statistiksel analizler i?in kategorik verilerin de?erlendirilmesinde Fischer's exact test, X2 testi sürekli de?i?kenler i?in ise ba??ms?z t testi kullan?lm??t?r. Bulgular: Hastalar?n hepsinde lezyonlar abdominal subkutan?z ya? dokusu veya rektus kas? i?inde hipoekoik solid nodüller halinde izlendiler. ADE boyutlar?yle tekrarlayan sezeryan say?lar? ve son ge?irilen operasyon tarihiyle hastaneye ba?vuru zaman? aras?nda anlaml? korelasyon mevcuttu (P<0.05). Büyük ADE'lerde artm?? santral kanlanma g?rülmekteydi (P<0.05). Siklik a?r? kü?ük ?aptaki lezyonlarda (P<0.05), sürekli a?r? ise büyük lezyonlarda s?kt? (P<0.05). Sonu?: Lezyonlardaki a?r?n?n non-spesifik ?zelli?i, kitlenin palpe edilemeyi?i nedeniyle ADE'nin do?ru tan?s? s?kl?kla g?zden ka?maktad?r. US ve RDUS bulgular?n?n klinik verilerle uygun bir ?ekilde korelasyonu kesin tan?ya büyük ?l?üde katk?da bulunacakt?r.