Value of in vitro acoustic radiation force impulse application on uterine adenomyosis

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This in vitro study found that acoustic radiation force impulse elastography can differentiate adenomyosis tissue from normal myometrium, as adenomyosis tissue demonstrated significantly higher elasticity.

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This prospective case-control study assessed whether in vitro acoustic radiation force impulse (ARFI) and color elastography could differentiate uterine adenomyosis from normal myometrium using 90 hysterectomy specimens. Specimens were categorized histopathologically into a study group with adenomyosis (n=28) and a control group without adenomyosis (n=62), and tissue elasticity was compared between groups. Tissue with adenomyosis showed significantly higher elasticity values than normal myometrium (p<0.01), and uterine fibroids also demonstrated higher ARFI values than normal myometrium (p<0.01). This paper is centrally about endometriosis and/or adenomyosis — specifically uterine adenomyosis, evaluating ARFI elastography to distinguish adenomyosis tissue from normal myometrium.

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Abstract

Purpose Adenomyosis is the presence of endometrial glandular and stromal tissue in the myometrium. This phenomenon can be the cause of excessive bleeding and menstrual pain in premenopausal women. Diagnosis of adenomyosis may present difficulty with conventional methods such as ultrasound and magnetic resonance imaging. Frequently, diagnosis is accomplished retrospectively based on the hysterectomy specimen.

Materials and methods

This is a prospective case control study done in vitro on 90 patients’ hysterectomy specimens. Acoustic radiation force impulse (ARFI) and color elastography were used to determine the elasticity of hysterectomy specimens of patients undergoing indicated surgeries. Based on histopathological examinations, two groups were formed: a study group (n = 28—with adenomyosis) and a control group (n = 62—without adenomyosis).

Results

Elasticity measurements of tissue with adenomyosis were observed to be significantly higher than measurements of normal myometrial tissue (p < 0.01). Uterine fibroids were found to have higher values on ARFI study compared to normal myometrial tissues (p < 0.01).

Conclusion

The findings lead to the conclusion that adenomyosis tissue is significantly softer than the normal myometrium. ARFI was found to be beneficial in differentiating myometrial tissue with adenomyosis from normal myometrial tissue. It was found to be feasible and beneficial to implement ARFI in daily gynecology practice for diagnosis of adenomyosis. Similar content being viewed by others

References

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Elasticity Imaging Techniques Adenomyosis Adenomyosis Adenomyosis Case-Control Studies Female Humans Hysterectomy Leiomyoma Leiomyoma Leiomyoma Leiomyoma Middle Aged Myometrium Myometrium Myometrium Myometrium Prospective Studies Single-Blind Method

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