الفهرس 
ADENOMYOSISOnly 14 pages are availabe for public view
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Abstract
Adenomyosis is defined by the abnormal location of endometrial tissue within the myometrium associated with hypertrophy or hyperplasia of the myometrial stroma. Adenomyosis is an estrogen-dependent disease similar to endometriosis and it regresses rapidly after the menopause.
Leiomyomas, more commonly known as fibroids, are the most prevalent solid gynecological benign tumors of the uterus. They originate from clonal expansion of a single cell in the myometrium. Because of their hormonally‐responsive nature, fibroids mainly affect women during their reproductive years, and typically regress following menopause.
The clinical signs and symptoms in leiomyoma and adenomyosis overlap substantially, making a definite clinical diagnosis difficult many a times. As the treatment protocols are very different, accurate preoperative diagnosis is vital for proper management. Several imaging methods have been used to differentiate between adenomyosis and leiomyoma with varying success. Because it is more sensitive, less angle-dependent, and not susceptible to aliasing, power Doppler sonography has the potential to detect fluctuations in blood flow, with results superior to those of frequency-based color Doppler sonography, particularly in situations of low-velocity blood flow 3D power Doppler ultrasonography can be applied to differentiate between uterine adenomyosis and leiomyoma, and it may reduce the number of false positives by detailed investigations. The use of three dimensional (3D) imaging and power Doppler improve the objective and reproducible assessment of a vascularity of a volume. Currently available 3D/4-dimensional volume ultrasound imaging can produce images of the female pelvis of comparable quality and orientation to those of MRI and CT but without radiation and at relatively lower cost.
This study aimed to investigate the value of 3D power Doppler ultrasonography in the differentiation of uterine adenomyosis and leiomyoma. This study is a Prospective observational study that was performed at the departments of Obstetrics & Gynaecology, department of Radiology and Department of Pathology in Elmenoufia University hospital.
This study included 157 patients who were admitted to the obstetrics & gynaecology department over a period of 3 years; from March 2017 to March 2020, with clinical symptoms of abnormal uterine bleeding with or without dysmenorrhoea, lump abdomen, chronic pelvic pain and were diagnosed as leiomyoma of uterus and/or adenomyosis based on clinical examination. Informed written patients consents were obtained. And the study was conducted after the approval of the university ethical committee.
All patients underwent examination with two dimensional ultrasound examinations for lesions evaluation with respect to its morphology, number, size and echotexture.Three-dimensional power Doppler ultrasound was performed preoperative as well to provid data related to tumor size, tumor volume, vascular location (location), vascular index (VI), flow index (FI), and vascular-flow index (VFI). During examination, the Doppler settings were altered.