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Adenomyosis in endometriosis--prevalence and impact on fertility. Evidence from magnetic resonance imaging.

机译：子宫内膜异位症中的腺肌病-患病率及其对生育力的影响。来自磁共振成像的证据。

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Sir,We read with great interest the paper by Kunz et al. entitled 'Adenomyosis in endometriosis - prevalence and impact on fertility. Evidence from magnetic resonance imaging' (Kunz et al., 2005). The authors found a higher incidence of uterine adenomyosis in women with endometriosis than in women without endometriosis and suggested that adenomyosis could be a determinant of infertility (Kunz et al, 2005). However, this article raises issues concerning the magnetic resonance (MR) imaging protocol used to diagnose adenomyosis.Concerning the imaging technique itself, the authors directly adopted a protocol used in a study published five years previously (Kunz et al, 2000) that may not be optimal for the diagnosis of adenomyosis. First, a 1.5-T pelvic phased-array coil with a 256 x 512 matrix offers better spatial resolution than a 1-T body coil with a matrix of 154 x 256, particularly for the detection of hyperintense myometrial spots, which are the findings most specific to adenomyosis. Second, the usefulness of fat-saturated turbo-spin echo sequences for the detection of adenomyosis has never been demonstrated. Third, breath-hold T2-weighted sequences (true fast imaging with steady-state precession and turbo-inversion-recovery sequences) offer better differentiation between focal adenomyosis and uterine contraction, optimize the accuracy of MR imaging for the diagnosis of adenomyosis and reduce interobserver variability, while fast spin-echo T2-weighted images and breath-hold T2-weighted sequences appear to have similar accuracy (Bazot et ah, 2003).
机译：主席先生，我们非常感兴趣地阅读了Kunz等人的论文。题为“子宫内膜异位症的子宫腺肌病-患病率及其对生育力的影响”。磁共振成像的证据”（Kunz等，2005）。作者发现子宫内膜异位症妇女子宫腺肌症的发生率高于无子宫内膜异位症妇女的子宫腺肌病的发生率，并建议子宫腺肌病可能是不孕症的决定因素（Kunz等，2005）。但是，本文提出了有关用于诊断子宫腺肌病的磁共振成像协议的问题，关于成像技术本身，作者直接采用了五年前发表的一项研究中使用的协议（Kunz等，2000）。最适合诊断子宫腺肌病。首先，具有256 x 512矩阵的1.5 T骨盆相控阵线圈比具有154 x 256矩阵的1-T身体线圈具有更好的空间分辨率，尤其是对于高强度肌层斑点的检测，这是大多数发现特定于子宫腺肌病。其次，从未证明过脂肪饱和涡轮自旋回波序列对检测腺肌病的有用性。第三，屏气式T2加权序列（具有稳态进动和涡轮反转恢复序列的真正快速成像）可更好地区分局灶性子宫腺肌病和子宫收缩，优化MR成像的准确性，以诊断子宫腺肌病并减少观察者可变性，而快速自旋回波T2加权图像和屏气T2加权序列似乎具有相似的准确性（Bazot等，2003）。

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