CONTROVERSIAL ISSUES OF RADIOLOGIC DIAGNOSIS OF ADENOMYOSIS IN REPRODUCTIVE LOSSES

In: Kuban Scientific Medical Bulletin · 2019 · vol. 26(2) , pp. 173–190 · doi:10.25207/1608-6228-2019-26-2-173-190 · W2946606474
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This review analyzes radiologic diagnostic data for adenomyosis in reproductive loss to identify research areas in imaging standardization, classification, and prediction methods for healthy childbearing.

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This paper analyzes published evidence on radiologic diagnosis of adenomyosis in women with reproductive problems, using searches in E-Library, PubMed, and the Cochrane Library for ultrasound and MRI approaches, including measures of the junctional zone. It reports that imaging methods have priority for detecting early adenomyosis, and their diagnostic value increases when evaluating causes of implantation failures. The review highlights major controversies and limitations in current radiologic practice, including lack of standardization, inconsistent disease classification, and challenges in assessing diagnostic accuracy and prognostic value during and after treatment. It concludes that future research should address optimal imaging timing, improve informative criteria for 3D reconstruction and MRI, and develop prognostic tools for pregnancy continuation and treatment monitoring. This paper is centrally about adenomyosis radiologic diagnosis and its role in reproductive losses (including infertility and implantation failure contexts), directly relating to adenomyosis in the endometriosis/adenomyosis research corpus.

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Abstract

Aim . The aim is to analyze the data thus far published on the radiologic diagnosis of adenomyosis in patients with reproductive problems in order to determine promising areas for further scientifi c research. Materials and methods . An information search for subsequent analysis was performed using E-Library, PubMed and CochraneLibrary electronic bibliographic databases with the following keywords: “ultrasound diagnosis of adenomyosis”, “MRI adenomyosis”, “junctional zone adenomyosis”, “ultrasound adenomyosis”, “diagnosis adenomyosis”, “magnetic resonance imaging adenomyosis”, “adenomyosis junction”. Results . Imaging techniques are prioritized in diagnosing the initial incidence of adenomyosis. The value of such techniques increases when analyzing the causes of implantation failures. Key issues associated with the modern radiologic diagnosis and monitoring of adenomyosis during treatment have been considered on the basis of the standardization of studies, classifi cation of the disease, assessment of the diagnostic accuracy and prognostic value of imaging techniques in patients with reproductive losses and infertility. Conclusion . Promising areas of scientifi c research are found to be the specifi cation of optimal diagnostic timeframes, informativity of diagnostic criteria for 3D reconstruction, MRI, elastography, angiography, as well as the development of prediction methods for healthy childbearing and monitoring the treatment effectiveness.
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СПОРНЫЕ ВОПРОСЫ ЛУЧЕВОЙ ДИАГНОСТИКИ АДЕНОМИОЗА ПРИ РЕПРОДУКТИВНЫХ ПОТЕРЯХ https://doi.org/10.25207/1608-6228-2019-26-2-173-190 Аннотация Цель. Анализ опубликованных данных по проблеме лучевой диагностики аденомиоза у пациенток с репродуктивными проблемами для определения перспективных направлений дальнейшего научного поиска. Материалы и методы. Поиск и анализ информации, опубликованной в электронных библиографических базах данных E-Library, PubMed и CochraneLibrary по ключевым словам: ультразвуковая диагностика аденомиоза, МРТ аденомиоз, переходная зона аденомиоз, ultrasound adenomyosis, diagnosis adenomyosis, magnetic resonance imaging adenomyosis, adenomyosis junction. Результаты. Визуализирующие методы являются приоритетными в диагностике начальной степени распространенности аденомиоза. Ценность методик возрастает при анализе причин имплантационных неудач. В статье рассматриваются основные проблемы современной лучевой диагностики и мониторинга аденомиоза на фоне лечения: стандартизация исследований, классификация заболевания, оценка диагностической точности и прогностической ценности методов визуализации у пациенток с репродуктивными потерями и бесплодием. Заключение. Перспективными направлениями научного поиска являются уточнение оптимальных сроков выполнения исследования, информативности диагностических критериев для 3D-реконструкции, МРТ, эластографии, ангиографии, разработка методов прогноза для вынашивания беременности и мониторинга эффективности лечения. Об авторах А. В. ПоморцевРоссия доктор медицинских наук, профессор, заведующий кафедрой лучевой диагностики, ул. Красных Партизан, д. 6/2, г. Краснодар, 350012 Ю. В. Грушевская Россия ассистент кафедры лучевой диагностики, ул. им. Митрофана Седина, д. 4, г. Краснодар, 350063 Т. Б. 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Допплерографические особенности внутреннего эндометриоза тела матки на фоне консервативной стероидной гормональной терапии. Кубанский научный медицинский вестник. 2012; 1(130): 110–114. Рецензия Для цитирования: Поморцев А.В., Грушевская Ю.В., Макухина Т.Б. СПОРНЫЕ ВОПРОСЫ ЛУЧЕВОЙ ДИАГНОСТИКИ АДЕНОМИОЗА ПРИ РЕПРОДУКТИВНЫХ ПОТЕРЯХ. Кубанский научный медицинский вестник. 2019;26(2):173-190. https://doi.org/10.25207/1608-6228-2019-26-2-173-190 For citation: Pomortsev A.V., Grushevskaya Yu.V., Makukhina T.B. CONTROVERSIAL ISSUES OF RADIOLOGIC DIAGNOSIS OF ADENOMYOSIS IN REPRODUCTIVE LOSSES. Kuban Scientific Medical Bulletin. 2019;26(2):173-190. (In Russ.) https://doi.org/10.25207/1608-6228-2019-26-2-173-190 JATS XML

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