The aim of this review was to provide an updated assessment of the present diagnostic tools and clinical symptoms and signs to evaluate uterine fibroids (UFs) on the basis of current guidelines, recent scientific evidence, and a PubMed and Google Scholar search for peer-reviewed original and review articles related to clinical signs and diagnosis of UFs. Approximately 50%–75% of UFs are considered nonclinically relevant. When present, the most common symptoms are abnormal uterine bleeding, pelvic pain and/or bulk symptoms, and reproductive failure. Transvaginal ultrasound is recommended as the initial diagnostic modality because of its accessibility and high sensitivity, although magnetic resonance imaging appears to be the most accurate diagnostic tool to date in certain cases. Other emerging techniques, such as saline infusion sonohysterography, elastography, and contrast-enhanced ultrasonography, may contribute to improving diagnostic accuracy in selected cases. Moreover, artificial intelligence has begun to demonstrate its ability as a complementary tool to improve the efficiency of UF diagnosis. Therefore, it is critical to standardize descriptions of transvaginal ultrasound images according to updated classifications and to individualize the use of the different complementary diagnostic tools available to achieve precise uterine mapping that can lead to targeted therapeutic approaches according to the clinical context of each patient.

中文翻译：

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青春期至更年期肌瘤的临床症状和诊断


本次综述的目的是根据当前指南、最新科学证据以及 PubMed 和 Google Scholar 搜索同行评审的结果，对现有诊断工具以及临床症状和体征进行更新评估，以评估子宫肌瘤 (UF)与 UF 的临床症状和诊断相关的原创文章和评论文章。大约 50%–75% 的 UF 被认为是非临床相关的。当出现时，最常见的症状是异常子宫出血、盆腔疼痛和/或大量症状以及生殖障碍。尽管磁共振成像在某些情况下似乎是迄今为止最准确的诊断工具，但由于其可及性和高灵敏度，经阴道超声被推荐作为初始诊断方式。其他新兴技术，例如盐水输注宫腔超声造影、弹性成像和对比增强超声检查，可能有助于提高特定病例的诊断准确性。此外，人工智能已经开始展示其作为补充工具提高UF诊断效率的能力。因此，根据更新的分类标准化经阴道超声图像的描述，并个性化使用不同的补充诊断工具来实现精确的子宫测绘，从而根据每个患者的临床情况采取有针对性的治疗方法至关重要。