Role of ultrasonography in the evaluation of disease severity and treatment efficacy in adenomyosis

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Ultrasonography, especially with elastography and contrast-enhanced techniques, shows promise for guiding medication and evaluating treatment efficacy in adenomyosis management.

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This review examines how ultrasonography is used to evaluate disease severity and treatment efficacy in adenomyosis, highlighting diagnostic and follow-up roles of standard ultrasound as well as newer techniques. It summarizes evidence that elastography and contrast-enhanced ultrasonography (CEUS) can improve diagnostic accuracy, aid differential diagnosis, and support assessment of treatment response after medication or ablation, with the goal of guiding long-term management. The paper explicitly notes that no new data were created or analyzed and presents an overview rather than original comparative results. This paper is centrally about endometriosis and adenomyosis — it is centrally about adenomyosis ultrasonography for severity assessment and treatment efficacy, with endometriosis only tangentially present in broader diagnostic imaging context.

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Abstract

BACKGROUND: Adenomyosis is a benign disorder characterized by the presence of ectopic endometrial glands and stroma within the myometrium. The main clinical manifestations of adenomyosis are dysmenorrhea, menorrhagia, and infertility, which affect patients' quality of life. Recently, with advancements in imaging techniques, magnetic resonance imaging, and ultrasonography have become the main diagnostic tools for adenomyosis. In addition to the diagnosis and differential diagnosis of adenomyosis, ultrasonography can also be used to evaluate the severity of adenomyosis. The emergence of new techniques, such as elastography and contrast-enhanced ultrasonography (CEUS), has significantly improved the accuracy of ultrasound-based diagnosis of adenomyosis. These two imaging tools can also be used for the differential diagnosis of adenomyosis and the evaluation of treatment efficacy after medication or ablation procedure. OBJECTIVE: we review the efficacy of ultrasonography as a diagnostic tool for adenomyosis. We also aim to introduce the potential of ultrasound imaging in the evaluation of the severity of this disease, as well as the application of elastography and contrast-enhanced ultrasonography (CEUS) in its diagnosis. RESULTS AND CONCLUSION: Our findings reveal the potential value of ultrasonography combined with elastography and/or CEUS as medication guidance and efficacy evaluation tools in the long-term management of adenomyosis.
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Abstract

Background Adenomyosis is a benign disorder characterized by the presence of ectopic endometrial glands and stroma within the myometrium. The main clinical manifestations of adenomyosis are dysmenorrhea, menorrhagia, and infertility, which affect patients’ quality of life. Recently, with advancements in imaging techniques, magnetic resonance imaging, and ultrasonography have become the main diagnostic tools for adenomyosis. In addition to the diagnosis and differential diagnosis of adenomyosis, ultrasonography can also be used to evaluate the severity of adenomyosis. The emergence of new techniques, such as elastography and contrast-enhanced ultrasonography (CEUS), has significantly improved the accuracy of ultrasound-based diagnosis of adenomyosis. These two imaging tools can also be used for the differential diagnosis of adenomyosis and the evaluation of treatment efficacy after medication or ablation procedure.

Objective

we review the efficacy of ultrasonography as a diagnostic tool for adenomyosis. We also aim to introduce the potential of ultrasound imaging in the evaluation of the severity of this disease, as well as the application of elastography and contrast-enhanced ultrasonography (CEUS) in its diagnosis.

Results

and Conclusion Our findings reveal the potential value of ultrasonography combined with elastography and/or CEUS as medication guidance and efficacy evaluation tools in the long-term management of adenomyosis. Similar content being viewed by others Data Availability Data availability is not applicable to this article as no new data were created or analyzed in this study

References

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J Cancer Res Ther 16(2):365–371. https://doi.org/10.4103/jcrt.jcrt_769_18 Cheng CQ, Zhang RT, Xiong Y, Chen L, Wang J, Huang GH et al (2015) Contrast-enhanced ultrasound for evaluation of high-intensity focused ultrasound treatment of benign uterine diseases: retrospective analysis of contrast safety. Medicine (Baltimore) 94(16):e729. https://doi.org/10.1097/MD.0000000000000729 Funding This work was funded by the National Key R&D Program of China (Grant No. 2022YFC2704002), National Natural Science Foundation of China (Grant No. 82071621), and Major Basic Research of Natural Science Foundation of Shandong Province (Grant No. ZR2021ZD34). Author information Authors and Affiliations Contributions RQ: manuscript writing and literature review; YM: manuscript writing and editing; GW: manuscript writing and editing, and project development. Corresponding author Ethics declarations Conflicts of interest The authors have no relevant financial or non-financial interests to disclose. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Ren, Q., Yuan, M. & Wang, G. Role of ultrasonography in the evaluation of disease severity and treatment efficacy in adenomyosis. Arch Gynecol Obstet 309, 363–371 (2024). https://doi.org/10.1007/s00404-023-07034-4 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00404-023-07034-4

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Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis

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