EP26.01: Value of “elasto strain ratio” ultrasound elastography in the diagnosis of adenomyosis: preliminary study

Elastography is an ultrasound-based imaging technique visualising the stiffness of the examined region. This technique enables to match the elasticity of organs with a range of colours and depicts the strain ratios on a colour map. Adenomyosis is one of the most extensive pathologies of the uterus wall, secondary to leiomyomas. The characteristic adenomyosis changes in the issue ultrastructure may modify the stiffness of the myometrium, which can be detected by ultrasound elastography. The aim of the study was to assess the accuracy of ultrasound elastography in the diagnosis of adenomyosis. We performed transvaginal ultrasound examinations in fifty two women aged 26 - 45 years. 23 women who presented without any uterine pathology in ultrasonography were included in a control group and 29 women suspected of having adenomyosis were included in study group. Diagnosis of adenomyosis was set in presence of globular uterine configuration, myometrial anterior-posterior asymmetry, heterogeneous myometrial echotexture, subendometrial cysts and poor definition of the endometrial-myometrial interface and presence of dysmenorrhea, and/or menorrhagia. Finally the elastography option was activated. Elastographic evaluation of the myometrium was performed using Alpinion E-CUBE 15 EX equipped with “Elasto Strain Ratio” software. The stiffness of adenomyosis changes was compared to the stiffness of normal myometrium and “Elasto Strain Ratio” was calculated. “Elasto Strain Ratio” of myometrium in group of healthy women was calculated as 0.96 (range 0.81 – 0.99). In group of women suffering from adenomyosis “Elasto Strain Ratio” was 0.69 (range 0.51 – 0.88). The results of the study indicate a decrease of the myometrial stiffness estimated in patients with adenomyosis. This study showed that, the use of elastography in addition to conventional ultrasound could help to diagnose uterine adenomyosis.