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



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).


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).


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.


Elastosonography Adenomyosis Acoustic radiation force impulse Ultrasound 


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.


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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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