Comprehensive method of ultrasound diagnosis of adenomyosis

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BACKGROUND: There are currently no uniform standards for adenomyosis diagnosis, so the search for the most informative methods is an urgent task. This article presents modern views on the diagnosis of adenomyosis and the role of ultrasound in its diagnostics.

AIM: The aim of this study was to determine the diagnostic capabilities of ultrasound in the diffuse form of adenomyosis.

MATERIALS AND METHODS: This study included 164 patients aged 22 to 43 years old, who had a comprehensive ultrasound examination done. The points were calculated and the presence or absence of adenomyosis, as well as its severity, were determined using the developed scale. The sequential implementation of six ultrasound techniques were used for a comprehensive ultrasound assessment of adenomyosis: assessment of the myometrium echostructure homogeneity; assessment of the ratio of the anterior and posterior uterine wall thicknesses; compression elastography; assessment of the junctional zone in the 3D mode; assessment of the uniformity of the junctional zone thickness along uterine walls; vascularization of the myometrium in the Power Doppler 3D Glass Body mode.

RESULTS: We have developed the comprehensive ultrasound method of adenomyosis diagnostics. The sensitivity of the method was 95%, and the specificity was 100%. The positive predictive value was 100%, and the negative predictive value was 90%. The accuracy of the method was 97%.

CONCLUSIONS: The developed scoring system for the comprehensive assessment of adenomyosis allows for an independent assessment of the myometrium for each criterion, summarizing the scores and, therefore, assessing the presence and severity of adenomyosis more objectively and reliably. The high sensitivity and specificity of this technique allows recommending it for use by ultrasound specialists.

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作者简介

Stanislava Nagorneva

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: stanislava_n@bk.ru
ORCID iD: 0000-0003-0402-5304
SPIN 代码: 5109-7613
Researcher ID: К-3723-2018

MD, Cand. Sci. (Med.)

俄罗斯联邦, Saint Petersburg

Maria Shalina

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: amarus@inbox.ru
ORCID iD: 0000-0002-5921-3217
SPIN 代码: 6673-2660
Scopus 作者 ID: 57200072308
Researcher ID: A-7180-2019

MD, Cand. Sci. (Med.)

俄罗斯联邦, Saint Petersburg

Maria Yarmolinskaya

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; North-Western State Medical University named after I.I. Mechnikov

Email: m.yarmolinskaya@gmail.com
ORCID iD: 0000-0002-6551-4147
SPIN 代码: 3686-3605
Scopus 作者 ID: 7801562649
Researcher ID: P-2183-2014

MD, Dr. Sci. (Med.), Professor, Professor of the Russian Academy of Sciences

俄罗斯联邦, Saint Petersburg

Elena Netreba

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

编辑信件的主要联系方式.
Email: dr.netlenka@yandex.ru
ORCID iD: 0000-0002-0485-3612
SPIN 代码: 9193-3154
俄罗斯联邦, Saint Petersburg

参考

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2. Fig. 1. Evaluation of the severity of adenomyosis, 2D mode: a: moderate; b: significant

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3. Fig. 2. Assessment of the thickness of the uterine walls in adenomyosis: asymmetry of the uterine walls

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4. Fig. 3. Elastography: a: type 2b; b: type 3

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5. Fig. 4. Evaluation of the transient zone in 3D mode: a: normal; b: increased

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6. Fig. 5. Uniformity of the transient zone: a: uniform; b: uneven

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7. Fig. 6. Vascularization of the myometrium in the power Doppler 3D glass body mode: a: moderate; b: significantly uniform

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