Ultrasound elastography in the diagnosis of adenomyosis


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Abstract

Aim. To optimize diagnostic evaluation of the myometrium using ultrasound elastography (UE) technique (compression and shear waves) for differential diagnosis and to determine the optimal access and scale of surgery in patients with adenomyotic changes in the myometrium. Materials and methods. The study comprised 120patients managed at the V.I. Kulakov NMRC for OG&P of Minzdrav of Russia. The patients were divided into groups categorized according to myometrial abnormalities identified by ultrasound examination and surgical treatment of 96/120 patients, and morphological confirmation of the diagnosis. The study group (group 1) included 36 women aged 23 to 42 with manifestations of adenomyosis (diffuse and nodular forms of varying severity). Group 2 included 60 patients aged 25-46 with uterine fibroids of various sizes and locations, the absence of adenomyosis, according to preliminary ultrasound and subsequent morphological examination of surgical specimens of uterine fibroids. Group 3 (control group) included 24 outpatients aged 19 to 65 without manifestations of the reproductive system disorders, significant laboratory and instrumental test abnormalities, and unchanged myometrium according to ultrasonography. The preliminary (stage 1) study included a standard protocol of gynecological ultrasonography; stage 2 of the research included a protocol of the UE: compression elastography (CEG) and shear wave elastography (SWE). Results. The stiffness of uterine fibroids and adenomyotic lesions was significantly higher than that of unchanged myometrium, which allows UE techniques (CEG and SWE) to be used in the diagnosis of myometrial diseases with high diagnostic accuracy. Still, the feasibility of using CEG and SWE in the differential diagnosis of adenomyosis and uterine fibroids is limited. Conclusion. The findings of the present study can be integrated into the clinical practice of diagnostic medical sonographers, radiologists, obstetrician-gynecologists, oncologists, and surgeons.

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About the authors

Alexandr N. Sencha

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: a_sencha@oparina4.ru

Lyudmila M. Kondratovich

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: klm80sm@mail.ru

Anatoliy G. Bykov

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: a_bykov@oparina4.ru

Leyla V. Adamyan

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: aleyla@inbox.ru

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