OBJECTIVE To evaluate the ultrasonographic presence of different forms of endometriosis and the associated clinical symptoms in adolescent women. DESIGN Retrospective observational study. SETTING University hospital. PATIENT(S) Two hundred and seventy women aged 12-20 years referred to the gynecologic ultrasound unit from January 2014 to June 2019. INTERVENTION(S) Two-dimensional, three-dimensional, and power Doppler ultrasound (US) pelvic examination (transvaginal or transrectal in pre-sexually active adolescents) were performed in all included adolescents. Medical history was collected for each patient before the scan. MAIN OUTCOME MEASURE(S) All possible locations of endometriosis evaluated and recorded using a dedicated ultrasound mapping sheet and severity of painful symptoms evaluated through a visual analogue scale (VAS). RESULT(S) Dysmenorrhea was detected in 147 (54.4%) of 270 patients and heavy menstrual bleeding in 76 (28.1%) of 270. At least one ultrasound feature of endometriosis was identified in 36 (13.3%) of 270 cases. Ovarian endometriomas were found in 22 (11%) patients, adenomyosis in 16 (5.2%), and deep infiltrating endometriosis (DIE) in 10 (3.7%). Ultrasound signs of endometriosis were found in 21% of adolescents who reported dysmenorrhea and 33% with dyspareunia. The presence of DIE at ultrasound was associated with bowel symptoms in 33% of patients and associated with dyspareunia in 25% of patients. CONCLUSION(S) The detection rate of pelvic endometriotic lesions at ultrasound was 13%. The rates of dysmenorrhea, dyspareunia and heavy menstrual bleeding in adolescents with endometriosis ultrasound signs were statistically significantly higher compared with those without. In patients with dysmenorrhea, the detection rate of pelvic endometriosis at ultrasound increased to 20%. Professionals involved with teens should be aware of the clinical presentation of endometriosis to reduce the delay between the onset of symptoms and the diagnosis, referring these young women to dedicated centers.

中文翻译：

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青春期和子宫内膜异位症：症状、超声征象和早期诊断

目的 评估青春期女性不同形式子宫内膜异位症的超声表现及其相关临床症状。设计 回顾性观察研究。设置大学医院。患者（S） 270 名 12-20 岁的女性于 2014 年 1 月至 2019 年 6 月转诊至妇科超声科。 干预（S）二维、三维和能量多普勒超声（美国）盆腔检查（经阴道或经直肠在性活跃的青少年中）在所有包括的青少年中进行。在扫描前收集每位患者的病史。主要结果测量所有可能的子宫内膜异位症位置使用专用的超声绘图表进行评估和记录，并通过视觉模拟量表 (VAS) 评估疼痛症状的严重程度。结果 270 名患者中有 147 名 (54.4%) 检测到痛经，270 名患者中有 76 名 (28.1%) 出现大量月经出血。270 名患者中有 36 名 (13.3%) 至少发现了子宫内膜异位症的一项超声特征。22 例 (11%) 患者发现卵巢子宫内膜异位症，16 例 (5.2%) 发现子宫腺肌病，10 例 (3.7%) 发现深部浸润性子宫内膜异位症 (DIE)。21% 报告痛经的青少年和 33% 的性交痛青少年发现子宫内膜异位症的超声征象。超声检查 DIE 的存在与 33% 的患者的肠道症状有关，并与 25% 的患者的性交困难有关。结论（S）盆腔子宫内膜异位病变超声检出率为13%。痛经的发生率，与没有子宫内膜异位症超声征象的青少年相比，有子宫内膜异位症超声征象的青少年的性交困难和大量月经出血在统计学上显着升高。在痛经患者中，超声检查盆腔子宫内膜异位症的检出率提高到20%。与青少年有关的专业人员应该了解子宫内膜异位症的临床表现，以减少症状出现和诊断之间的延迟，将这些年轻女性转介到专门的中心。