Adenomiose em pacientes com endometriose profunda: aspectos clínicos, histológicos e radiológicos / Adenomyosis in patients with deep endometriosis: clinical, histological and radiological aspects

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Objectives: The objective of this study was to analyze the relationship between endometriosis and adenomyosis diagnosed by magnetic resonance imaging (MRI). Patients and Methods: From February 2004 to March 2008, 152 patients with histological diagnosis of endometriosis were allocated in two groups, according to the presence (group A) or not (group B) of adenomyosis diagnosed by MRI. Junction zone length and myometrial cysts presence were considered the main criteria of adenomyosis diagnosis. Other aspects such as uterine posterior wall lesions, "subserosal adenomyosis", junction zone length until uterine serosa, undefined junction zone and focal adenomyosis were also studied. The results of MRI adenomyosis analysis were compared to endometriosis in terms of ASRM staging, sites of lesions and histological classification. Results: The prevalence of adenomyosis in patients with endometriosis was 42,76%. When compared to the group without adenomyosis, patients with endometriosis and adenomyosis, diagnosed by MRI, presented more dysmenorrhea (61,53% in group A and 44,83% in group B, p=0,041) and deep dyspareunia (64,61% in group A and 41,38% in group B, p=0,005), association with stage IV endometriosis (50,77% in group A and 33,34% in group B, p=0,03), endometriotic lesions affecting rectosigmoid (49,23% in group A and 32,18% in group B, p=0,033) and association with pure or mixed undifferentiated endometriosis (52,31% in group A and 34,48% in group B, p=0,028). Patients with lesions affecting rectosigmoid and stage IV endometriosis had an association with adenomyosis in uterine posterior wall, with thicker junction zone, myometrial cysts and "subserosal adenomyosis" in MRI study. Conclusions: The results of this study show correlation between adenomyosis and worse prognosis deep endometriosis, mainly involving the rectosigmoid.

ASSUNTO(S)

endometriosis imagem por ressonância magnética magnetic resonance imaging adenomiose endometriose adenomyosis

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