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Journal of Medical Ultrasonics

, Volume 45, Issue 3, pp 425–430 | Cite as

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

  • Tevfik Berk Bildaci
  • Halime Cevik
  • Birnur Yilmaz
  • Guldeniz Aksan Desteli
Original Article
  • 67 Downloads

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.

Keywords

Elastosonography Adenomyosis Acoustic radiation force impulse Ultrasound 

Notes

Compliance with ethical standards

Ethical statements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study.

Conflict of interest

There are no financial or other relations that could lead to a conflict of interest.

References

  1. 1.
    McElin TW, Bird CC. Adenomyosis of the uterus. Obstet Gynecol Annu. 1974;3:425.PubMedGoogle Scholar
  2. 2.
    Parker JD, Leondires M, Sinaii N, et al. Persistence of dysmenorrhea and nonmenstrual pain after optimal endometriosis surgery may indicate adenomyosis. Fertil Steril. 2006;86:711.CrossRefPubMedGoogle Scholar
  3. 3.
    Andres MP, Borrelli GM, Ribeiro J, et al. Transvaginal ultrasound for the diagnosis of adenomyosis: systematic review and meta-analysis. J Minim Invasive Gynecol. 2017;29 (pii: S1553-4650 31113-5).Google Scholar
  4. 4.
    Hoyos LR, Benacerraf B, Puscheck EE. Imaging in endometriosis and adenomyosis. Clin Obstet Gynecol. 2017;60:27–37.CrossRefPubMedGoogle Scholar
  5. 5.
    Champaneria R, Abedin P, Daniels J, et al. Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy. Acta Obstet Gynecol Scand. 2010;89:1374.CrossRefPubMedGoogle Scholar
  6. 6.
    Reinhold C, Tafazoli F, Mehio A, et al. Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation. Radiographics. 1999; 19 Spec No: S147.Google Scholar
  7. 7.
    Vinci V, Saldari M, Sergi ME, et al. MRI, US or real-time virtual sonography in the evaluation of adenomyosis? Radiol Med. 2017;122:361–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Acar S, Millar E, Mitkova M, et al. Value of ultrasound shear wave elastography in the diagnosis of adenomyosis. Ultrasound. 2016;24:205–13.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Czuczwar P, Wozniak S, Szkodziak P, et al. Elastography improves the diagnostic accuracy of sonography in differentiating endometrial polyps and submucosal fibroids. J Ultrasound Med. 2016;35:2389–95.CrossRefPubMedGoogle Scholar
  10. 10.
    Vanhoutte A, Fellah L, Galant C, et al. Contribution of sonoelastography to the characterization of breast lesions. JBR-BTR. 2008;91:187–94.PubMedGoogle Scholar
  11. 11.
    Tranquart F, Bleuzen A, Pierre-Renoult P, et al. Elastosonography of thyroid lesions. J Radiol. 2008;89:35–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Miyagawa T, Tsutsumi M, Matsumura T, et al. Real-time elastography for the diagnosis of prostate cancer: evaluation of elastographic moving images. Jpn J Clin Oncol. 2009;39:394–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Karaman E, Arslan H, Çetin O, et al. Comparison of placental elasticity in normal and pre-eclamptic pregnant women by acoustic radiation force impulse elastosonography. J Obstet Gynaecol Res. 2016;42:1464–70.CrossRefPubMedGoogle Scholar
  14. 14.
    Tessarolo M, Bonino L, Camanni M, et al. Elastosonography: a possible new tool for diagnosis of adenomyosis? Eur Radiol. 2011;21:1546–52.CrossRefPubMedGoogle Scholar
  15. 15.
    Ami O, Lamazou F, Mabille M, et al. Real-time transvaginal elastosonography of uterine fibroids. Ultrasound Obstet Gynecol. 2009;34:486–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Hobson MA, Kiss MZ, Varghese T, et al. In vitro uterine strain imaging: preliminary results. J Ultrasound Med. 2007;26:899–908.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Soliman AA, Wojcinski S, Degenhardt F. Ultrasonographic examination of the endometrium and myometrium using acoustic radiation force impulse (ARFI) imaging technology: an initial experience with a new method. Clin Hemorheol Microcirc. 2015;59:235–43.PubMedGoogle Scholar

Copyright information

© The Japan Society of Ultrasonics in Medicine 2017

Authors and Affiliations

  1. 1.OB/GYN DepartmentBaskent University Istanbul Education and Research HospitalIstanbulTurkey
  2. 2.Radiology DepartmentBaskent University Istanbul Education and Research HospitalIstanbulTurkey
  3. 3.Radiology DepartmentOkan UniversityIstanbulTurkey

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