子宫平滑肌瘤是最常见的妇科和盆腔肿瘤,据报道,到50岁时,高达80%的女性。虽然大多数是无症状的,子宫平滑肌瘤,根据大小,number,和位置会导致大量症状,异常子宫出血(AUB),不孕症或反复怀孕。超声检查(USG)仍然是诊断平滑肌瘤的第一线,并且是初步评估异常子宫出血的最合适的成像方式。为了标准化术语并确定AUB的原因,国际妇产科联合会(FIGO)开发了一种基于缩写PALM-COEIN(息肉;子宫腺肌病;平滑肌瘤;恶性肿瘤和增生;凝血病;排卵功能障碍;子宫内膜;医源性;尚未分类)的分类系统.对于平滑肌瘤的L类,当存在时,描述了二级和三级亚分类系统,将粘膜下肿块与其他肿块区分开,并对肿块与子宫内膜和浆膜的关系进行分类。随着用于治疗平滑肌瘤的新型微创技术的发展,均匀表征,映射,平滑肌瘤的分类是决定最佳治疗方法的必要条件。虽然最近在MR上审查了这个分类系统,根据我们的知识,在放射学文献中尚未对超声进行审查。我们在此对所有FIGO类平滑肌瘤的USG图像进行图片审查,以提供放射学报告的标准指南。
Uterine leiomyomas are the most common gynecological and pelvic neoplasm, reported in up to 80 percent of women by age 50. While the majority are asymptomatic, uterine leiomyomas, depending on size, number, and location can result in bulk symptoms, abnormal uterine bleeding (AUB), infertility or recurrent pregnancy loss. Ultrasonography (USG) remains first-line for the diagnosis of leiomyomas and is the most appropriate imaging modality for the initial assessment of abnormal uterine bleeding. In an effort to standardize nomenclature and identify causes of AUB, the International Federation of Gynecology and Obstetrics (
FIGO) developed a classification system based on the acronym PALM-COEIN (polyp; adenomyosis; leiomyoma; malignancy and hyperplasia; coagulopathy; ovulatory dysfunction; endometrial; iatrogenic; and not yet classified). For the L category of leiomyoma, when present, a secondary and tertiary subclassification system is described distinguishing submucosal masses from others and categorizing the relationship of the mass to the endometrium and serosa. With advancements in newer minimally to non-invasive techniques developed for the management of leiomyomas, uniform characterization, mapping, and classification of leiomyomas is necessary to decide the optimal therapeutic approach. While this classification system has recently been reviewed on MR, to our knowledge, it has not been reviewed on ultrasound in the radiology literature. We hereby present a pictorial
review of USG images of all the
FIGO categories of leiomyomas to provide a standard guide for radiology reporting.