Role of three-dimensional ultrasound and Doppler in differentiating leiomyoma and adenomyosis of uterus

NohaF Ahmed, NasserK Abd El Aal, HamedE ELLakwa, ShaimaaA Hassanein, HeshamA Ammar
In: Menoufia Medical Journal · 2022 · vol. 35(2) , pp. 762 · doi:10.4103/mmj.mmj_214_21 · W4292084363
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Three-dimensional power Doppler ultrasound differentiates uterine leiomyoma and adenomyosis by assessing vascularity location and Doppler indices, revealing decreased vascularity and increased resistance in adenomyosis.

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Abstract

ObjectiveThe purpose of this study is to evaluate the importance of three-dimensional (3D) power Doppler ultrasound (US) in the diagnosis and differentiation of leiomyoma and adenomyosis of the uterus.BackgroundThe clinical presentation of adenomyosis and leiomyoma overlaps. The 3/4D US imaging has been currently able to produce female pelvis images that are comparable with magnetic resonance imaging and computerized tomography images in both quality and orientation, with the benefit of being without radiation and low cost.Patients and methodsThis study included female patients clinically diagnosed as having uterine leiomyoma and/or adenomyosis and were indicated for hysterectomy. By Doppler velocimetry with the use 3D power Doppler, the waveforms of the ascending main branch of the uterine artery were obtained on both sides of the cervix. Calculation of the resistance index (RI) and pulsatility index (PI) was done in an automatic manner. The averages of arteries on both sides were taken.ResultsThe vascularity of most of the leiomyoma lesions was peripheral and of all of the adenomyosis lesions was central. The adenomyosis group showed significantly decreased vascular index, flow index, and vascular-flow index mean values (P < 0.01), significantly increased uterine artery RI mean values (P < 0.05), and highly significantly increased PI values (P < 0.01).ConclusionThree-dimensional US imaging with power Doppler can increase the accuracy of differentiation between leiomyoma and adenomyosis cases. Significant differences were noted in the vascularity site and Doppler indices.

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Condition tags

adenomyosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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