ULTRASOUND CRITERIA FOR DIAGNOSIS AND MONITORING OF DRUG THERAPY OF COMBINED PROLIFERATIVE DISEASES OF THE UTERUS

Kedrova Genrikhovna AG, Леваков Сергей Александрович, Nechaeva Evgen'evna OE, Tazitdinov Khallilovich RH, Chelnokova Nikolaevna NN
In: Journal of Clinical Practice · 2014 · vol. 5(3) , pp. 25–34 · doi:10.17816/clinpract5325-34 · W2791990667
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

Transvaginal ultrasonography accurately diagnoses and monitors genital endometriosis, endometrial hyperplasia, and uterine fibroids before and after dienogest treatment, indicating potential non-surgical management.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This paper discusses ultrasound-based criteria used to diagnose and monitor drug therapy in women with “combined proliferative diseases of the uterus,” focusing on how sonographic features can be applied clinically. It describes the diagnostic and follow-up approach at a high level, emphasizing ultrasound standards and specific sonographic findings for uterine benign proliferative conditions, with an overall goal of supporting assessment of treatment response. The main limitation is that the work is framed as criteria/clinical practice guidance rather than as a new controlled study, and the available text provides no detailed prospective outcomes, sample size, or explicit effect estimates. Relevance to endometriosis: adenomyosis and uterine benign disorders are discussed in the broader uterine-proliferative context through cited sources on adenomyosis (and general uterine disorders), though the paper’s main focus is ultrasound criteria for diagnosis and drug-therapy monitoring of combined uterine proliferative diseases.

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Abstract

The aim of the paper was to evaluate the diagnostic accuracy of transvaginal tenderness-guided ultrasonography in the identification of location of genital endometriosis, endometrial hyperplasia and uterine fibroids before and after treatment dienogest. It is a selective progestin for the treatment of endometriosis. Adenomyosis was diagnosed when a poorly defined area of abnormal echo-texture (decreased or increased echogenicity, heterogeneous echotexture, myometrial cysts) presented in myometrium. Typical ultrasonic changes of efficacy were: homogeneity of myometrium; clear and intense contours of uterine fibroid with increased echogenicity; reduction of the echogenic endometrial stripe with the average echogenicity and clear lines of myo- and endometrium with a reduction in local blood. These criteria can be used to select non-surgical management of patients. In cases where a poorly defined area of abnormal echotexture (decreased or increased echogenicity, heterogeneous echotexture, myometrial cysts) did not change the surgery or the embolization of artery uterine is required. The preferred imaging modality for the evaluation of uterine on therapeutic alternatives to hysterectomy and myomectomy is transvaginal ultrasonography.
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Abstract

About the authors Kedrova Genrikhovna AG Email: [email protected] Levakov Aleksandrovich SA Nechaeva Evgen'evna OE Tazitdinov Khallilovich RH Chelnokova Nikolaevna NN Email: [email protected]

References

- Parazzini F, Mais V, Cipriani S. GISE. Determinants of adenomyosis in women who underwent hysterectomy for benign gynecological conditions: results from a prospective multicentric study in Italy. Eur J Obstet Gynecol Reprod Biol 2009; 143:103-106. - Гуриев Т.Д., Сидорова И.С., Унанян А.Л. Сочетание миомы матки и аденомиоза. Пособие для врачей. М.: Медицинское информационное агентство. 2012. С. 34. - Taran FA, Weaver AL, Coddington CC. Characteristics indicating adenomyosis coexisting with leiomyomas: a case-control study. Hum Reprod. 2010 May;25(5):1177-82. - Stewart EA, Strauss JF. Disorders of the uterus: leiomyomas, adenomyosis, endometrial polyps, abnormal uterine bleeding, intrauterine adhesions and painful menses. In: Yen and Jaffe's Reproductive Endocrinology. Barbieri RL, Strauss JF, eds. 2004; 5th edn. Philadelphia: Elsevier. 713-34. - Brosens I, Puttemans P, Benagiano G. Endometriosis: a life cycle approach? Am J Obstet Gynecol. 2013 Mar 15. pii: S0002-9378(13) 00263-9.: 10.1016/j.ajog.2013.03.009 - Gordts S, Brosens JJ, Fusi L. Uterine adenomyosis: a need for uniform terminology and consensus classification. Reprod Biomed Online. 2008 Aug;17(2):244-8. - Пособие по освоению Международной статистической классификации болезней и проблем, связанных со здоровьем (десятый пересмотр). Для врачей и специалистов по статистике. Спб.: 1998. - Ascher SM, Jha RC, Reinhold C. Benign myometrial conditions: leiomyomas and adenomyosis. Top Magn Reson Imaging. 2003 Aug; 14(4):281-304. - Tamai K, Koyama T, Umeoka S. Spectrum of MR features in adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006 Aug;20(4):583-602. - Мерц Э. Ультразвуковая диагностика в акушерстве и гинекологии. Том 2. Гинекология. Пособие для врачей. М.: Медпресс Информ. 2011, стр.256-260. - Стрижаков А.Н., Давыдов А.И., Пашков В.М., и соавт. Доброкачественные заболевания матки. Пособие для врачей. М.: Гэотар-Медиа. 2011, стр.69-72. - Зыкин Б.И. Стандартизация ультразвуковых исследований в гинекологии. Дис... докт. мед. наук М.: 2002. - Медведев М.В., Хохолин B.Л. Ультразвуковое исследование матки. Клиническое руководство по ультразвуковой диагностике. Под ред. Митькова В.В., Медведева М.В. М.: Видар, 1997, Т3, с. 76-119. - Practice Committee of American Society of Reproductive Medicine (ASRM), 2008 - Kepkep K, Tuncay YA, G`ynhmer G. Trans-vaginal sonography in the diagnosis of adenomyosis: which findings are most accurate? Ultrasound Obstet Gynecol. 2007 Sep;30(3):341-5.

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endometriosisadenomyosis

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