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

• Published in: Journal of medical ultrasonics (2001) Vol. 45; no. 3; pp. 425 - 430
• Main Authors: Bildaci, Tevfik Berk, Cevik, Halime, Yilmaz, Birnur, Desteli, Guldeniz Aksan
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.07.2018; Springer; Springer Nature B.V
• Subjects: Acoustic properties; Acoustics; Adenomyosis - diagnostic imaging; Adenomyosis - pathology; Adenomyosis - surgery; Case-Control Studies; Diagnosis; Elasticity; Elasticity Imaging Techniques; Endometriosis; Female; Fibroids; Gynecology; Humans; Hyperplasia; Hysterectomy; Imaging; Leiomyoma - diagnostic imaging; Leiomyoma - pathology; Leiomyoma - surgery; Magnetic resonance imaging; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Menopause; Middle Aged; Myometrium - diagnostic imaging; Myometrium - pathology; Myometrium - surgery; Original Article; Prospective Studies; Radiation; Radiology; Single-Blind Method; Sound waves; Ultrasonic imaging; Ultrasonic testing; Ultrasound; Uterine Neoplasms - diagnostic imaging; Uterine Neoplasms - pathology; Uterine Neoplasms - surgery; Elastosonography; Ultrasound; Adenomyosis; Acoustic radiation force impulse
• ISSN: 1346-4523; 1613-2254
• DOI: 10.1007/s10396-017-0845-y

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.