ULTRASOUND EXAMINATION POSSIBILITIES IN ADENOMYOSIS DIAGNOSTICS IN PATIENTS WITH REPRODUCTIVE LOSS

А. В. Поморцев, T. B. Makuhina, YU. V. GRUSHEVSKAYA
In: Kuban Scientific Medical Bulletin · 2018 · vol. 25(6) , pp. 142–148 · doi:10.25207/1608-6228-2018-25-6-142-148 · W2906277157
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⚙ AI-generated summary by claude@2026-06, 2026-06-11 ⓘ

Ultrasound with color Doppler and 3D reconstruction identified junctional zone abnormalities and reduced vascularization in patients with infertility and early pregnancy loss, indicating minimal adenomyosis prevalence.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

The study evaluated the ability of pelvic ultrasound incorporating color Doppler mapping (CDK) and three-dimensional (3D) volumetric reconstruction to diagnose minimal-spread adenomyosis in 40 women with unspecified infertility and early pregnancy losses, compared with 35 healthy controls. All participants underwent transvaginal pelvic ultrasound in B/CDK/3D modes with assessment of the junctional zone on days 5–7 and 18–22 of the menstrual cycle. In the main group, the junctional zone and endometrium showed cycle-phase discrepancies and reduced vascularization at later cycle days, along with indistinct junctional zone contours and increased junctional zone thickness measures and ratios that remained phase-independent (reported p-values included). The paper concludes that this ultrasound approach can identify a high-risk group for minimal-spread adenomyosis, and it does not explicitly state a key limitation such as histologic confirmation. This paper is centrally about adenomyosis—specifically ultrasound (CDK and 3D) diagnostic features of minimal-spread adenomyosis in patients with reproductive loss.

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Abstract

Aim. The research was designed to study the possibilities of ultrasound examination with Color Doppler imaging (CDI) and three-dimensional volumetric reconstruction (3D) in the diagnostics of adenomyosis of minimal prevalence in patients with unspecified infertility and reproductive losses at the early stages of gestation. Materials and methods. 40 patients with unspecified infertility and early pregnancy loss (the main group) and 35 healthy patients (the control group) were examined in the course of the study. All patients underwent small pelvic ultrasound in В / CDI / 3D-modes with an assessment of the junctional zone (JZ) on days 5-7 and 18-22 of the menstrual cycle (MC). Results. In the main group, there was a discrepancy between the structure of the endometrium and the phase of the cycle at 5-7 days of the MC, a decrease in vascularization of the JZ at 18-22 days of the MC, a local increase in blood flow in the endometrium in phases 1 and 2 of the MC; the fuzziness of the junctional zone, an increase in min and max thickness of the junctional zone, the difference between them, as well as the ratio of max thickness of the junctional zone to the thickness of the uterus wall regardless of the phase of the MC (p = 0.005; 0.0001; 0.005; 0.03; 0.0004; 0, 0001; 0.0001; 0.0001; 0.0001 respectively). Conclusion. Ultrasonography with the CDI and 3D reconstruction allows us to identify a high-risk group by the presence of a minimal prevalence of adenomyosis in the patients with unspecified infertility and reproductive losses at the early stages of gestation.
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ВОЗМОЖНОСТИ УЛЬТРАЗВУКОВОГО ИССЛЕДОВАНИЯ В ДИАГНОСТИКЕ НАЧАЛЬНОГО АДЕНОМИОЗА У ПАЦИЕНТОК С РЕПРОДУКТИВНЫМИ ПОТЕРЯМИ https://doi.org/10.25207/1608-6228-2018-25-6-142-148 Аннотация Цель. Изучить возможности ультразвукового исследования с использованием цветового допплеровского картирования (ЦДК) и трехмерной объемной реконструкции (3Д) в диагностике аденомиоза минимальной распространенности у пациенток с неуточненным бесплодием и репродуктивными потерями в ранних сроках гестации. Материалы и методы. Обследованы 40 пациенток с неуточненным бесплодием и ранними потерями беременности (основная группа), 35 здоровых пациенток (контроль). Всем пациенткам выполнялась эхография малого таза в В/ЦДК/3Д-режимах с оценкой переходной зоны (ПЗ) на 5-7 и 18-22 дни менструального цикла (МЦ). Результаты. В основной группе обнаружено несоответствие структуры эндометрия фазе цикла на 5-7 дни МЦ, снижение васкуляризации ПЗ на 18-22 дни МЦ, локальное усиление кровотока в эндометрии в 1 и 2 фазах МЦ; нечеткость контуров ПЗ, увеличение min и max толщины ПЗ, разницы между ними, а также отношения max толщины ПЗ к толщине стенки матки независимо от фазы МЦ (р=0,005; 0,0001; 0,005; 0,03; 0,0004; 0,0001; 0,0001; 0,0001; 0,0001 соответственно). Заключение. Эхография с ЦДК и 3Д-реконструкцией позволяет выделить группу высокого риска по наличию аденомиоза минимальной распространенности у пациенток с неуточненным бесплодием и репродуктивными потерями в ранних сроках гестации. Ключевые слова Об авторах А. В. ПоморцевРоссия ул. Седина, 4, Краснодар, 350063. Т. Б. Макухина Россия ул. Седина, 4, Краснодар, 350063. Ю. В. Грушевская Россия ул. Седина, 4, Краснодар, 350063. Список литературы 1. Dueholm M. Uterine adenomyosis and infertility, review of reproductive outcome after in vitro fertilization and surgery Acta Obstetricia et Gynecologica Scandinavica. 2017; 96: 715-726. 2. Benagiano G., Brosens I., Habiba M. Structural and molecular features of the endomyometrium in endometriosis and adenomyosis. Hum Reprod Update. 2014; 20: 386-402. 3. Vercellini P., Consonni D., Barbara G., Buggio L., Frattaruolo M.P., Somigliana E. Adenomyosis and reproductive performance after surgery for rectovaginal and colorectal endometriosis: a systematic review and meta-analysis. Reprod Biomed Online. 2014; 28: 704-713. 4. Van den Bosch T, Dueholm M, Leone FP, Valentin L, Rasmussen CK, Votino A, Van Schoubroeck D, Landolfo C, Installé AJ, Guerriero S, Exacoustos C, Gordts S, Benacerraf B, D'Hooghe T, De Moor B, Brölmann H, Goldstein S, Epstein E, Bourne T, Timmerman D. Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group. Ultrasound Obstet Gynecol. 2015; 46(3): 284-98. DOI: 10.1002/uog.14806. Epub 2015 Aug 10. 5. Puente JM, Fabris A, Patel J, Patel A, Cerrillo M, Requena A, et al. Аdenomyosis in infertile women: prevalence and the role of 3D ultrasound as a marker of severity of the disease. Reprod Biol Endocrinol. 2016; 14: 60 р. 6. Жигаленко А.Р., Карахалис Л.Ю., Папова НС. Клинико-диагностические параллели при аденомиоз-ассоциированном бесплодии. Кубанский научный медицинский вестник. 2017; 24(4): 65-73. 7. Gordts S, Brosens JJ, Fusi L, Benagiano G, Brosens I. Uterine adenomyosis: a need for uniform terminology and consensus classification. Reprod Biomed Online. 2008; 24(4): 17-18. 8. Rasmussen CK, Glavind J, Madsen LD, Uldbjerg N, Dueholm M. Repeatability of junctional zone measurements using 3-dimensional transvaginal sonography in healthy fertile women. J Ultrasound Med. 2016; 35: 497-508. 9. Lazzarin N, Exacoustos C, Vaquero E, De FG, Manfellotto D, Zupi E. Uterine junctional zone at three-dimensional transvaginal ultrasonography in patients with recurrent miscarriage: a new diagnostic tool? Eur J Obstet Gynecol Reprod Biol. 2014; 174: 128-32. 10. Exacoustos C., Brienza L., DI Giovanni A., Szabolcs B., RomaninI M. E., Zupi E. and ArduiniD. Adenomyosis: threedimensional sonographic findings of the junctional zone and correlation with histology. Ultrasound Obstet Gynecol 2011; 37: 471-479. 11. Maubon A, Faury A, Kapella M, Pouquet M, Piver P. Uterine junctional zone at magnetic resonance imaging: a predictor of in vitro fertilization implantation failure. J: Obstet Gynaecol Res. 2010; 36: 611-618. 12. Makukhina T.B, PomortsevA.V., Lobanov K.A. Doppler sonography peculiarities of uterus tissual blood flow of patients with adenomyosis treated with steroid hormonal therapy Ultrasound in Obstetrics and Gynecology. 2011; 38: 265 р. 13. Макухина Т.Б., Лобанов К.А., Поморцев А.В., Пономарев В.В. Допплерографические особенности внутреннего эндометриоза тела матки на фоне консервативной стероидной гормональной терапии. Кубанский научный медицинский вестник. 2012; 1(130): 110-114. 14. Адамян Л.В., Яроцкая Е.Л. Генитальный эндометриоз: дискуссионные вопросы и альтернативные подходы к диагностике и лечению. Журнал акушерства и женских болезней. 2002; 3: 103-111. Рецензия Для цитирования: Поморцев А.В., Макухина Т.Б., Грушевская Ю.В. ВОЗМОЖНОСТИ УЛЬТРАЗВУКОВОГО ИССЛЕДОВАНИЯ В ДИАГНОСТИКЕ НАЧАЛЬНОГО АДЕНОМИОЗА У ПАЦИЕНТОК С РЕПРОДУКТИВНЫМИ ПОТЕРЯМИ. Кубанский научный медицинский вестник. 2018;25(6):142-148. https://doi.org/10.25207/1608-6228-2018-25-6-142-148 For citation: Pomortsev A.V., Makuhina T.B., Grushevskaya Y.V. ULTRASOUND EXAMINATION POSSIBILITIES IN ADENOMYOSIS DIAGNOSTICS IN PATIENTS WITH REPRODUCTIVE LOSS. Kuban Scientific Medical Bulletin. 2018;25(6):142-148. (In Russ.) https://doi.org/10.25207/1608-6228-2018-25-6-142-148 JATS XML

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