Comprehensive method of ultrasound diagnosis of adenomyosis

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.

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.

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%.

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. Full Text About the authors Stanislava V. Nagorneva The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott Email: [email protected] ORCID iD: 0000-0003-0402-5304 SPIN-code: 5109-7613 ResearcherId: К-3723-2018 MD, Cand. Sci. (Med.) Russian Federation, Saint PetersburgMaria A. Shalina The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott Email: [email protected] ORCID iD: 0000-0002-5921-3217 SPIN-code: 6673-2660 Scopus Author ID: 57200072308 ResearcherId: A-7180-2019 MD, Cand. Sci. (Med.) Russian Federation, Saint PetersburgMaria I. 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: [email protected] ORCID iD: 0000-0002-6551-4147 SPIN-code: 3686-3605 Scopus Author ID: 7801562649 ResearcherId: P-2183-2014 MD, Dr. Sci. (Med.), Professor, Professor of the Russian Academy of Sciences Russian Federation, Saint PetersburgElena A. Netreba The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott Author for correspondence. Email: [email protected] ORCID iD: 0000-0002-0485-3612 SPIN-code: 9193-3154 Russian Federation, Saint Petersburg

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