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2018 | OriginalPaper | Buchkapitel

32. Uterus

verfasst von : Prof. Dr. med. M. Hoopmann, Dr. med. W. Dürr, Prof. Dr. med. T. Van den Bosch, Prof. Dr. med. D. Timmerman, Univ.-Prof. Dr. med. C. Brezinka

Erschienen in: Ultraschalldiagnostik in Geburtshilfe und Gynäkologie

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Die sonographische Untersuchung des Uterus gehört zu den am häufigsten durchgeführten Untersuchungen des gynäkologischen Alltags. Im Kinder- und Jugendlichenalter kann die Erkennung und korrekte Einordnung von genitalen Fehlbildungen von Bedeutung sein. In der Prämenopause steht die funktionelle Beurteilung des Endometriums und Myometriums im Vordergrund. Typische benigne Veränderungen, die mittels transvaginaler Sonographie erkannt werden können, sind Polypen, Myome, Adenomyosis oder Endometriumhyperplasien. Maligne Veränderungen, welche überwiegend in der Peri- wie Postmenopause im Fokus stehen, stellen das Endometriumkarzinom und das sehr seltene Sarkom dar. Auch wenn die Sonographie hier keinen Nachweis eines effektiven Screenings erbringen konnte, so gehört sie in die onkologische Diagnostik obligat dazu.

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AAGL (American Association of Gynecologic Laparoscopists) (2012) AAGL practice report: practice guidelines for the diagnosis and management of submucous leiomyomas. J Minim Invasive Gynecol 19: 152–171

AFS (American Fertility Society) (1988) The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, mullerian anomalies and intrauterine adhesions. Fertil Steril 49: 944–955

Amant F, Coosemans A, Debiec-Rychter M (2009) Clinical management of uterine sarcomas. Lancet Oncol 10: 1188–1198

Ami O, Lamazou F, Mabille M, et al (2009) Real-time transvaginal elastosonography of uterine fibroids. Ultrasound Obstet Gynecol 34: 486–488

Bajka M, Badir S (2017) Fundus thickness assessment by 3D transvaginal ultrasound allows metrics-based diagnosis and treatment of congenital uterine anomalies. Ultraschall Med 38: 183–189

Bermejo C, Martinez Ten P, Cantarero R, et al (2010) Three-dimensional ultrasound in the diagnosis of Mullerian duct anomalies and concordance with magnetic resonance imaging. Ultrasound Obstet Gynecol 35: 593–601

Bermejo C, Mertinez Ten P, Recio M, et al (2014) Three-dimensional ultrasound and magnetic resonance imaging assessment of cervix and vagina in women with uterine malformations. Ultrasound Obstet Gynecol 43: 336–345

Bernaschek G, Lubec G, Schaller A (1984) Sonographic study of the growth of the uterus and ovaries between the ages of 1 and 14. Geburtshilfe Frauenheilkd 44: 727–730

Bezircioglu I, Baloglu A, Cetinkaya B, et al (2012) The diagnostic value of the Doppler ultrasonography in distinguishing the endometrial malignancies in women with postmenopausal bleeding. Arch Gynecol Obstet 285: 1369–1374

Blake RE (2007) Leiomyomata uteri: hormonal and molecular determinants of growth. J Natl Med Assoc 99: 1170–1184

Brucker SY, Rall K, Campo R, et al (2011) Treatment of congenital malformations. Semin Reprod Med 2: 101–112

Champaneria R, Abedin P, Daniels J, et al (2010) Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy. Acta Obstet Gynecol Scand 89: 1374–1384

Chan JK, Wu H, Cheung MK, et al (2007) The outcomes of 27,063 women with unstaged endometrioid uterine cancer. Gynecol Oncol 106: 282–288

Cheng WF, Lin HH, Torng PL, et al (1997) Comparison of endometrial changes among symptomatic tamoxifen-treated and nontreated premenopausal and postmenopausal breast cancer patients. Gynecol Oncol 66: 233–237

Cil AP, Tulunay G, Kose MF, et al (2010) Power Doppler properties of endometrial polyps and submucosal fibroids: a preliminary observational study in women with known intracavitary lesions. Ultrasound Obstet Gynecol 35: 233–237

Cohen I (2004) Endometrial pathologies associated with postmenopausal tamoxifen treatment. Gynecol Oncol 94: 256–266

Curtis KM, Hillis SD, Marchbanks PA, et al (2002) Disruption of the endometrial-myometrial border during pregnancy as a risk factor for adenomyosis. Am J Obstet Gynecol 187: 543–544

de Kroon CD, de Bock GH, Dieben SW, et al (2003a) Saline contrast hysterosonography in abnormal uterine bleeding: a systematic review and meta-analysis. BJOG 110: 938–947

de Kroon CD, Jansen FW, Louwé LA, et al (2003b) Technology assessment of saline contrast hysterosonography. Am J Obstet Gynecol 188: 945–949

De Smet F, De Brabanter J, Van den Bosch T, et al (2006) New models to predict depth of infiltration in endometrial carcinoma based on transvaginal sonography. Ultrasound Obstet Gynecol 27: 664–671

Deligdisch L, Kalir T, Cohen CJ, et al (2000) Endometrial histopathology in 700 patients treated with tamoxifen for breast cancer. Gynecol Oncol 78: 181–186

Denschlag D, Ulrich U, Emons G (2011) The diagnosis and treatment of endometrial cancer: progress and controversies. Dtsch Arztbl Int 108: 571–577

Devlieger R, D’Hooghe T, Timmerman D (2003) Uterine adenomyosis in the infertility clinic. Hum Reprod Update 9: 139–147

Dreisler E, Stampe Sorensen S, Ibsen PH, et al (2009) Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20–74 years. Ultrasound Obstet Gynecol 33: 102–108

Dueholm M (2006) Transvaginal ultrasound for diagnosis of adenomyosis: a review. Best Pract Res Clin Obstet Gynaecol 20: 569–582

Dueholm M, Lundorf E (2007) Transvaginal ultrasound or MRI for diagnosis of adenomyosis. Curr Opin Obstet Gynecol 19: 505–512

Dürr W (2015) Transvaginale Sonographie in der Gynäkologie. 2. Aufl. De Gruyter, Berlin

Exacoustos C, Brienza L, Di Giovanni A, et al (2011) Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology. Ultrasound Obstet Gynecol 37: 471–479

Exalto N, Stappers C, van Raamsdonk LA, Emanuel MH (2007) Gel instillation sonohysterography: first experience with a new technique. Fertil Steril 87: 152–155

Fleischer AC, Wheeler JE, Lindsay I, et al (2001) An assessment of the value of ultrasonographic screening for endometrial disease in postmenopausal women without symptoms. Am J Obstet Gynecol 184: 70–75

Furness S, Roberts H, Marjoribanks J, Lethaby A (2012) Hormone therapy in postmenopausal women and risk of endometrial hyperplasia. Cochrane Database Syst Rev 8: CD000402

Fusi L, Cloke B, Brosens JJ (2006) The uterine junctional zone. Best Pract Res Clin Obstet Gynaecol 20: 479–491

Gembruch U, Merz E (2011) Standardization of ultrasound diagnostics in gynecology. Ultraschall Med 32: 339–341

Ghi T, Casadio P, Kuleva M, et al (2009) Accuracy of three-dimensional ultrasound in diagnosis and classification of congenital uterine anomalies Fertil Steril 92: 808–813

Goldstein SR (2009) The role of transvaginal ultrasound or endometrial biopsy in the evaluation of the menopausal endometrium. Am J Obstet Gynecol 201: 5–11

Goldstein SR (2010) Modern evaluation of the endometrium. Obstet Gynecol 116: 168–176

Grab D, Merz E, Prömpeler H, et al (2011) Standards for ultrasound in gynecology. Ultraschall Med 32: 415–417

Grimbizis GF, Gordts S, Di Spiezo Sardo A et al, (2013) The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Human Reprod 28: 2032–2044

Gupta S, Jain M (1998) Incidental observations during routine laparoscopic sterilisation. J Indian Med Assoc 96: 365–366

He RH, Gao HJ, Li YQ, et al (2010) The associated factors to endometrial cavity fluid and the relevant impact on the IVF-ET outcome. Reprod Biol Endocrinol 8: 46

Hennig Y, Deichert U, Bonk U, et al (1999) Chromosomal translocations affecting 12q14-15 but not deletions of the long arm of chromosome 7 associated with a growth advantage of uterine smooth muscle cells. Mol Hum Reprod 5: 1150–1154

Ijland MM, Evers JL, Dunselman GA, et al (1996) Endometrial wavelike movements during the menstrual cycle. Fertil Steril 65: 746–749

Jacobs I, Gentry-Maharaj A, Burnell M, et al (2011) Sensitivity of transvaginal ultrasound screening for endometrial cancer in postmenopausal women: a case-control study within the UKCTOCS cohort. Lancet Oncol 12: 38–48

Kepkep K, Tuncay YA, Goynumer G, et al (2007) Transvaginal sonography in the diagnosis of adenomyosis: which findings are most accurate? Ultrasound Obstet Gynecol 30: 341–345

Kolankaya A, Arici A (2006) Myomas and assisted reproductive technologies: when and how to act? Obstet Gynecol Clin North Am 33: 145–152

Kunz G, Beil D, Deininger H, et al (1996) The dynamics of rapid sperm transport through the female genital tract: evidence from vaginal sonography of uterine peristalsis and hysterosalpingoscintigraphy. Hum Reprod 11: 627–632

Kunz G, Beil D, Huppert P, et al (2000) Structural abnormalities of the uterine wall in women with endometriosis and infertility visualized by vaginal sonography and magnetic resonance imaging. Hum Reprod 15: 76–82

Lee CL, Jain S, Wang CJ, et al (2001) Classification for endoscopic treatment of mullerian anomalies with an obstructive cervix. J Am Assoc Gynecol Laparosc 8: 402–408

Leone FP, Carsana L, Lanzani C, et al (2007) Sonohysterographic endometrial sampling and hysteroscopic endometrial biopsy: a comparative study. Ultrasound Obstet Gynecol 29: 443–448

Leone FP, Timmerman D, Bourne T, et al (2010) Terms, definitions and measurements to describe the sonographic features of the endometrium and intrauterine lesions: a consensus opinion from the International Endometrial Tumor Analysis (IETA) group. Ultrasound Obstet Gynecol 35: 103–112

Lermann J, Mueller A, Wiesinger E, et al (2011) Comparison of different diagnostic procedures for the staging of malformations associated with Mayer-Rokitansky-Kuster-Hauser syndrome. Fertil Steril 96: 156–159

Lev-Sagie A, Hamani Y, Imbar T, et al (2005) The significance of intrauterine lesions detected by ultrasound in asymptomatic postmenopausal patients. BJOG 112: 379–381

Leyendecker G, Kunz G, Noe M, et al (1998) Endometriosis: a dysfunction and disease of the archimetra. Hum Reprod Update 4: 752–762

Lyons EA, Taylor PJ, Zheng XH, et al (1991) Characterization of subendometrial myometrial contractions throughout the menstrual cycle in normal fertile women. Fertil Steril 55: 771–774

Matijevic R, Grgic O (2005) Predictive values of ultrasound monitoring of the menstrual cycle. Curr Opin Obstet Gynecol 17: 405–410

Mavrelos D, Ben-Nagi J, Holland T, et al (2010) The natural history of fibroids. Ultrasound Obstet Gynecol 35: 238–242

Naftalin J, Jurkovic D (2009) The endometrial-myometrial junction: a fresh look at a busy crossing. Ultrasound Obstet Gynecol 34: 1–11

Naftalin J, Nunes N, Hoo W, et al (2012) Endometrial cancer and ultrasound: why measuring endometrial thickness is sometimes not enough. Ultrasound Obstet Gynecol 39: 106–109

Nirmal D, Griffiths AN, Jose G, et al (2006) Warming Echovist contrast medium for hysterocontrastsonography and the effect on the incidence of pelvic pain. A randomized controlled study. Hum Reprod 21: 1052–1054

Okolo S (2008) Incidence, aetiology and epidemiology of uterine fibroids. Best Pract Res Clin Obstet Gynaecol 22: 571–588

Oppelt P, Renner SP, Brucker S, et al (2005) The VCUAM (Vagina Cervix Uterus Adnex-associated Malformation) classification: a new classification for genital malformations. Fertil Steril 84: 1493–1497

Parker WH (2007) Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril 87: 725–736

Parker WH, Fu YS, Berek JS (1994) Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing leiomyoma. Obstet Gynecol 83: 414–418

Peddada SD, Laughlin SK, Miner K, et al (2008) Growth of uterine leiomyomata among premenopausal black and white women. P Proc Natl Acad Sci USA 105: 19887–19892

Pepas L, Deguara C, Davis C (2012) Update on the surgical management of adenomyosis. Curr Opin Obstet Gynecol 24: 259–264

Perrot N, Frey I, Mergui JL, et al (2001) Picture of the month. Adenomyosis: power Doppler findings. Ultrasound Obstet Gynecol 17: 177–178

Polin SA, Ascher SM (2008) The effect of tamoxifen on the genital tract. Cancer Imaging 8: 135–145

Rein MS, Powell WL, Walters FC, et al (1998) Cytogenetic abnormalities in uterine myomas are associated with myoma size. Mol Hum Reprod 4: 83–86

Rozewicki S, Bielewicz W, Iwanicki M, et al (1992) Developmental anomalies of the uterus in a population of 3000 women with various causes of infertility. Ginekol Pol 63: 515–517

Ryan GL, Syrop CH, Van Voorhis BJ (2005) Role, epidemiology, and natural history of benign uterine mass lesions. Clin Obstet Gynecol 48: 312–324

Samuels TA, Awonuga A (2005) Second-trimester rudimentary uterine horn pregnancy: rupture after labor induction with misoprostol. Obstet Gynecol 106: 1160–1162

Savelli L, Testa AC, Mabrouk M, et al (2012) A prospective blinded comparison of the accuracy of transvaginal sonography and frozen section in the assessment of myometrial invasion in endometrial cancer. Gynecol Oncol 124: 549–552

Schmidt T, Nawroth F, Breidenbach M, et al (2005) Differential indication for histological evaluation of endometrial fluid in postmenopause. Maturitas 50: 177–181

Shushan A, Revel A, Rojansky N (2004) How often are endometrial polyps malignant? Gynecol Obstet Invest 58: 212–215

Stewart EA, Taran FA, Chen J, et al (2011) Magnetic resonance elastography of uterine leiomyomas: a feasibility study. Fertil Steril 95: 281–284

Takacs P, De Santis T, Nicholas MC, et al (2005) Echogenic endometrial fluid collection in postmenopausal women is a significant risk factor for disease. J Ultrasound Med 24: 1477–1481

Taran FA, Weaver AL, Coddington CC, et al (2010) Characteristics indicating adenomyosis coexisting with leiomyomas: a case-control study. Hum Reprod 25: 1177–1182

Tetlow RL, Richmond I, Manton DJ, et al (1999) Histological analysis of the uterine junctional zone as seen by transvaginal ultrasound. Ultrasound Obstet Gynecol 14: 188–193

Timmerman D, Verguts J, Konstantinovic ML, et al (2003) The pedicle artery sign based on sonography with color Doppler imaging can replace second-stage tests in women with abnormal vaginal bleeding. Ultrasound Obstet Gynecol 22: 166–171

Troiano RN, McCarthy SM (2004) Mullerian duct anomalies: imaging and clinical issues. Radiology 233: 19–34

Valentin L (2014) Ultrasound deserves to play a prominent role in the diagnosis and management of endometrial cancer. Ultrasound Obstet Gynecol 43: 483–487

Van den Bosch T, Verguts J, Daemen A, et al (2008) Pain experienced during transvaginal ultrasound, saline contrast sonohysterography, hysteroscopy and office sampling: a comparative study. Ultrasound Obstet Gynecol 31: 346–351

Van den Bosch T, Betsas G, Van Schoubroeck D, et al (2009) Gel infusion sonography in the evaluation of the uterine cavity. Ultrasound Obstet Gynecol 34: 711–714

Van den Bosch T, Van Schoubroeck D, Daemen A, et al (2011a) Lidocaine does not reduce pain perception during gel instillation sonography or subsequent office hysteroscopy: results of a randomized trial. Gynecol Obstet Invest 71: 236–239

Van den Bosch T, Van Schoubroeck D, Luts J, et al (2011b) Effect of gel-instillation sonography on Doppler ultrasound findings in endometrial polyps. Ultrasound Obstet Gynecol 38: 355–359

Van den Bosch T, Coosemans A, Morina M, et al (2012a) Screening for uterine tumours. Best Pract Res Clin Obstet Gynaecol 26: 257–266

Van den Bosch T, Van Schoubroeck D, Van Calster B, et al (2012b) Pre-sampling ultrasound evaluation and assessment of the tissue yield during sampling improves the diagnostic reliability of office endometrial biopsy. J Obstet Gynaecol 32: 173–176

Verma SK, Lev-Toaff AS, Baltarowich OH, et al (2009) Adenomyosis: sonohysterography with MRI correlation. AJR Am J Roentgenol 192: 1112–1116

Vessey MP, Villard-Mackintosh L, McPherson K, et al (1992) The epidemiology of hysterectomy: findings in a large cohort study. Br J Obstet Gynaecol 99: 402–407

Vitiello D, McCarthy S (2006) Diagnostic imaging of myomas. Obstet Gynecol Clin North Am 33: 85–95

Wamsteker K, Emanuel MH, de Kruif JH (1993) Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstet Gynecol 82: 736–740

Werbrouck E, Veldman J, Luts J, et al (2011) Detection of endometrial pathology using saline infusion sonography versus gel instillation sonography: a prospective cohort study. Fertil Steril 95: 285–288

Wetzstein R, Renn KH (1970) Arrangement of smooth muscle in the human uterus. Verh Anat Ges 64: 461–468

Wolfman W, Leyland N, Heywood M, et al (2010) Asymptomatic endometrial thickening. J Obstet Gynaecol Can 32: 990–999

Titel: Uterus
verfasst von: Prof. Dr. med. M. Hoopmann
Dr. med. W. Dürr
Prof. Dr. med. T. Van den Bosch
Prof. Dr. med. D. Timmerman
Univ.-Prof. Dr. med. C. Brezinka
Verlag: Springer Berlin Heidelberg
Buch: Ultraschalldiagnostik in Geburtshilfe und Gynäkologie
Print ISBN: 978-3-662-53661-2

Electronic ISBN: 978-3-662-53662-9

Copyright-Jahr: 2018
DOI: https://doi.org/10.1007/978-3-662-53662-9_32

Springerpflege

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