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Perdas hemáticas vaginais não associadas à gravidez – avaliação radiológica
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Advisor(s)
Abstract(s)
Introdução - A hemorragia vaginal é uma queixa frequente na mulher. É manifestação de várias entidades ginecológicas, contudo
existem patologias mais específicas da fase pré-menopausa ou pós-menopausa.
Objectivos - 1) Discussão das principais causas responsáveis por perdas hemáticas vaginais não relacionadas com a gravidez, nas
mulheres pré-menopausa e pós-menopausa. 2) Revisão dos achados radiológicos de cada uma destas patologias. 3) Salientar a
utilidade de cada técnica radiológica no seu diagnóstico.
Aspectos Radiológicos - A ecografia, incluindo a abordagem transvaginal é geralmente o primeiro método de imagem na avaliação
destas doentes. A histerossonografia, a TC e a RM podem também ser úteis no estudo de determinadas entidades.
A endometriose, a adenomiose e a infecção são causas especificamente encontradas em mulheres na pré-menopausa. A atrofia do
endométrio, carcinoma do endométrio e da vagina são características da fase pós-menopausa. O leiomioma, a hiperplasia do
endométrio, o pólipo, o tumor do ovário produtor de estrogéneos, o trauma e corpos estranhos são condições comuns aos dois
grupos.
Conclusão - As perdas hemáticas vaginais resultam de uma ampla variedade de entidades comuns e incomuns. É importante para
o radiologista conhecer as lesões menos frequentes para poder reconhecê-las. A ecografia e a RM são as técnicas com maior
utilidade no diagnóstico da patologia uterina, anexial e vaginal responsável por hemorragia vaginal.
Background - The vaginal bleeding is a frequent complaint of women. There is a wide spectrum of gynecologic sources, but there are some diseases that can be more specifically found in the premenopausal or in the posmenopausal period. Learning objectives - 1) To discuss the causes of vaginal bleeding non pregnancy-related in premenopausal and postmenopausal women. 2) To review the main imaging features of each one of these diseases. 3) To describe the utility of each imaging modality on the diagnosis of these pathologies. Imaging findings - US is usually the first imaging modality to evaluate these patients. Sonohysterography, CT and RM are also useful adjunct tools in the evaluation of certain entities. Endometriosis, adenomyosis and infection are causes specifically found in premenopausal women. Endometrial atrophy, endometrial and vaginal carcinomas are characteristic in posmenopausal women. Leiomyoma, hyperplasia, polyp, estrogen-producing ovarian tumor, trauma and foreign bodies can be observed in both groups. Conclusion - A wide variety of both usual and unusual entities can cause vaginal bleeding. It is important for the radiologist to be aware of the less frequent lesions in order to recognize them. US and MR are the most useful diagnostic tools in uterine, adnexal and vaginal pathology that are responsible for vaginal bleeding.
Background - The vaginal bleeding is a frequent complaint of women. There is a wide spectrum of gynecologic sources, but there are some diseases that can be more specifically found in the premenopausal or in the posmenopausal period. Learning objectives - 1) To discuss the causes of vaginal bleeding non pregnancy-related in premenopausal and postmenopausal women. 2) To review the main imaging features of each one of these diseases. 3) To describe the utility of each imaging modality on the diagnosis of these pathologies. Imaging findings - US is usually the first imaging modality to evaluate these patients. Sonohysterography, CT and RM are also useful adjunct tools in the evaluation of certain entities. Endometriosis, adenomyosis and infection are causes specifically found in premenopausal women. Endometrial atrophy, endometrial and vaginal carcinomas are characteristic in posmenopausal women. Leiomyoma, hyperplasia, polyp, estrogen-producing ovarian tumor, trauma and foreign bodies can be observed in both groups. Conclusion - A wide variety of both usual and unusual entities can cause vaginal bleeding. It is important for the radiologist to be aware of the less frequent lesions in order to recognize them. US and MR are the most useful diagnostic tools in uterine, adnexal and vaginal pathology that are responsible for vaginal bleeding.
Description
Keywords
Sistema genito-urinário Infecção Neoplasia Útero Hemorragia Genitourinary system Infection Neoplasm Uterus Hemorrhage
Citation
Maria Manuel Monteiro; Teresa Margarida Cunha. Abnormal Vaginal Bleeding – Imaging Evaluation, Acta Radiológica Portuguesa, 81, 53-61, 2009.