OP24.06: Elastography in gynecology: preliminary experience

Studies on the use of elastography have shown promising results in the diagnosis of lesions in the breast, liver and prostate. The aim of this pilot study was to investigate the possible use of transvaginal elastography in gynecology. Conventional B-mode ultrasonography with color Doppler was followed by dual-mode scanning with elastography imaging in a group of patients with various gynecological problems. We used the Accuvix V10 (Medison) with a 4–9 MHz transvaginal probe. In elastography, the relative stiffness of tissues was displayed with a color coded map. The results of the elastography images were evaluated subjectively and compared to those of the B-mode imaging. In a total of 50 patients B-mode ultrasonography revealed normal findings in 26 patients, one or more uterine fibroids in 16 patients, 8 adnexal masses, 2 cases suspicious for endometrial pathology and 3 cases of adenomyosis. Elastography gave no additional information in the group of patients with normal findings. Among the fibroid cases image quality was improved in 69% by using elastography mainly by making it easier to delineate the fibroids. In patients with adnexal masses, endometrial lesions and adenomyosis there was no clear improvement except for 1 patient where elastography helped to distinguish an ovarian fibroma from normal ovarian tissue. Elastography may be used in transvaginal ultrasound assessment of the female pelvis. Our preliminary experience suggests that it may prove to be useful for evaluation of uterine fibroids. More research is needed to assess the clinical value of elastography.