The significance of three-dimensional ultrasound in the assessment of the state of the endometrium in patients with diffuse and nodular forms of adenomyosis

Objective: To determine management tactics for patients with diffuse and nodular adenomyosis, by assessing the their functional state of the endometrium.

Materials and methods: Examinations were made in 104 patients who were ranged by groups Group 1 comprised 58 examinees with diffuse adenomyosis; Group 2 included 46 examinees with the nodular form. All the patients underwent three-dimensional ultrasound of pelvic organs. The investigators studied the thickness, volume and echostructure of the endometrium, indicators of volumetric blood flow: vascularization index (VI%); flow (FI) and vascular flow (VFI).

Results: The diffuse and nodular forms of adenomyosiosis are associated with the changes in the the thickness, the endometrial pattern, as well as with the hemodynamic parameters in the terminal branches of uterine arteries (hypovascularization, an increase in the angle-independent indices of blood flow velocity curves. The obvious uterine mucosal thinning particularly in patients with nodular adenomyosis, and which means the association with the disturbed endometrial functional state accompanied by a reduction in the implantation potential.

Conclusion: The patients with obvious endometrial thinning and the nodular form of adenomyosis, it is advisable to recommend a a reproductologist’s consultation to decide whether assisted reproductive technologies should be used. Three-dimensional ultrasound is an additional objective method for estimating the volume of the endometrium and hemodynamics in volume at the level of the basal and spiral arteries.