New possibilities of differential diagnosis of uterine fibroids and adenomyosis nodes based on a complex ultrasound assessment
- 作者: Shalina M.1, Nagorneva S.1,2, Yarmolinskaya M.1,3
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隶属关系:
- The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
- Sestroretskaya Multiprofile Clinic Ltd.
- North-Western State Medical University named after I.I. Mechnikov
- 期: 卷 71, 编号 5 (2022)
- 页面: 75-84
- 栏目: Original Research
- URL: https://journals.rcsi.science/jowd/article/view/125974
- DOI: https://doi.org/10.17816/JOWD110878
- ID: 125974
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详细
BACKGROUND: Ultrasound is widely used in routine practice to diagnose various forms of adenomyosis and uterine fibroids. However, due to the lack of unified criteria, hypo- or overdiagnosis of internal endometriosis is possible. Moreover, there are a number of difficulties in the differential diagnosis of nodular adenomyosis and uterine fibroids.
AIM: The aim of this study was to develop a complex technique for the differential diagnosis of uterine fibroids and adenomyosis nodes.
MATERIALS AND METHODS: We applied a complex ultrasound technique with a detailed and consistent application of the following tools — 3D reconstruction, elastography, color Doppler, 3D power Doppler (glass body mode). The study was conducted in 124 patients of reproductive age with subsequent intraoperative and histological confirmation of the diagnosis.
RESULTS: After the proposed ultrasound technique, uterine fibroids were diagnosed in 112 (90.3%) patients, of whom 85 (75.9%) patients had uterine fibroids combined with a diffuse form of internal endometriosis. Nodular adenomyosis was diagnosed in 12 (9.7%) patients. The additional examination and surgical treatment showed that the preliminary diagnosis of uterine fibroids was confirmed in 110 out of 112 women, and in two other cases, nodular adenomyosis was diagnosed. Eleven (91.7%) out of 12 patients were diagnosed correctly with nodular adenomyosis by the complex ultrasound examination, while in one case the preliminary diagnosis proved to be incorrect, with a conglomerate of three myomatous nodes detected as a result of surgical treatment. Thus, based on the technique we developed, the correct diagnosis was made in 121 (97.6%) patients. Misdiagnosis in three cases was associated with a history of a long-term medical treatment of adenomyosis and therefore Doppler and elastography results had lower sensitivity.
CONCLUSIONS: The development of the described complex ultrasound technique allows for accurately diagnosing the form of adenomyosis, identifying early forms of the disease and differentiating adenomyosis nodes from myomatous nodes, which is necessary for the correct diagnosis, the right choice of the management tactics and the necessary treatment.
作者简介
Maria Shalina
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
Email: amarus@inbox.ru
ORCID iD: 0000-0002-5921-3217
Scopus 作者 ID: 57200072308
Researcher ID: A-7180-2019
MD, Cand. Sci. (Med.)
俄罗斯联邦, Saint PetersburgStanislava Nagorneva
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; Sestroretskaya Multiprofile Clinic Ltd.
Email: stanislava_n@bk.ru
ORCID iD: 0000-0003-0402-5304
SPIN 代码: 5109-7613
Researcher ID: К-3723-2018
MD, Cand. Sci. (Med.)
俄罗斯联邦, Saint Petersburg; Saint PetersburgMaria Yarmolinskaya
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; North-Western State Medical University named after I.I. Mechnikov
编辑信件的主要联系方式.
Email: m.yarmolinskaya@gmail.com
ORCID iD: 0000-0002-6551-4147
SPIN 代码: 3686-3605
Scopus 作者 ID: 7801562649
MD, Dr. Sci. (Med.), Professor, Professor of the Russian Academy of Sciences
俄罗斯联邦, Saint Petersburg; Saint Petersburg参考
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