目的:我们的目的是回顾有关青少年子宫内膜异位症的非侵入性诊断的证据。
方法:按照SWiM报告指南编写系统综述。这项研究是在三个数据库(MEDLINE/PubMed,Scopus,和WebofScience)通过非侵入性方法确定有关青少年人群和子宫内膜异位症诊断的文章。搜索包括关键词\"子宫内膜异位症,\"\"青少年,\"\"诊断,\"\"超声波,\"和\"MRI。“只考虑了英语文章,2000年以前出版的那些被排除在外。确定的结果集中在临床症状上,超声(美国),磁共振成像(MRI)结果提示子宫内膜异位症。
结果:我们收录了26篇文章,主要包括病例系列和横断面研究。汇总分析涉及2,299名女性青少年(年龄范围8-25岁),临床怀疑,imaged,和/或手术证实的子宫内膜异位症。最常报告的症状是痛经,其次是慢性盆腔疼痛。在临床怀疑子宫内膜异位症的青少年中接受超声检查(美国),32.8%表现出至少一种子宫内膜异位症。在167例超声诊断的子宫内膜异位症患者中,48.5%有深部浸润型子宫内膜异位症(DIE),45.5%的患者检测到子宫内膜瘤.三项研究评估了MRI发现,结果显示,49.8%的患者出现子宫内膜异位症。
结论:痛经和慢性盆腔疼痛是青春期子宫内膜异位症的主要症状。尽管它们的诊断准确性各不相同,US和MRI已成为诊断该疾病的有价值的工具。虽然美国可能有局限性,特别是在检测细微病变时,核磁共振显示有希望,即使在以前的超声正常的情况下。早期识别和主动诊断对于改善青少年子宫内膜异位症的治疗至关重要。
OBJECTIVE: Our aim was to review the evidence concerning the non-invasive diagnosis of endometriosis in adolescents.
METHODS: A systematic review was written following the SWiM reporting guidelines. The study research was made across three databases (MEDLINE/PubMed, Scopus, and Web of Science) to identify articles about the adolescent population and the diagnosis of endometriosis through non-invasive methods. The search included the keywords \"endometriosis,\" \"adolescents,\" \"diagnosis,\" \"ultrasound,\" and \"MRI.\" Only English-language articles were considered, and those published prior to 2000 were excluded. The established outcomes focused on clinical symptoms, ultrasound (
US), and magnetic resonance imaging (MRI) findings suggestive of endometriosis.
RESULTS: We included 26 articles, mostly comprising case series and cross-sectional studies. The pooled analysis involved 2,299 female adolescents (age range 8-25 years old) with clinically suspected, imaged, and/or surgically confirmed endometriosis. The most frequently reported symptom was dysmenorrhea, followed by chronic pelvic pain. Among adolescents clinically suspected of endometriosis undergoing ultrasound (
US), 32.8% exhibited at least one sign of endometriosis. Of the 167 patients with ultrasound-diagnosed endometriosis, 48.5% had deep infiltrating endometriosis (DIE), and 45.5% had an endometrioma detected. Three studies assessed MRI findings, revealing that 49.8% presented with signs of endometriosis.
CONCLUSIONS: Dysmenorrhea and chronic pelvic pain stand out as key symptoms of adolescent endometriosis. Although their diagnostic accuracy varies,
US and MRI have emerged as valuable tools for diagnosing the disease. While the
US may have limitations, especially in detecting subtle lesions, MRI shows promise, even in cases with normal previous ultrasounds. Early recognition and proactive diagnosis are crucial for improving the management of endometriosis in adolescents.