Usage of ultrasonographic elastography in diagnosis of adenomyosis; controlled prospective study

USAGE OF ULTRASONOGRAPHIC ELASTOGRAPHY IN DIAGNOSIS OF ADENOMYOSIS; CONTROLLED PROSPECTIVE STUDY Adenomyosis, which is frequency of up to 70% in hysterectomy series, can cause infertility, abnormal uterine bleeding, chronic pain syndrome and shown in few cases its oncological potential. Altought diagnosis can be made with MRI, USG, CT and hysteroscopy, the definitive diagnosis is made by histopathological examination. Ultrasonographic elastography is a noninvasive imaging method which used to evaluate the mechanical properties of tissue. Shear wave elastography is a method that provides quantitative information about tissue stiffness. Our study included 56 female patients who were scheduled for hysterectomy for various indications in our hospital between April 2021 and February 2022. Patients underwent Swe examination before the operation are measured from uterine myometrium and lesions like adenomyosis and leiomyoma. Total of 69 measurements were included in the study. After the operation, the materials were divided into groups according to their histopathological examinations: group 1: normal myometrium, group 2: adenomyosis, group 3: leiomyoma. Emean values in kPa obtained from Swe measurement were compared with histopathological results. Kolmogorov smirnov and shapiro-wilk testused to get statistical analysis. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were analysed. The cut-off point value for differentiation between the groups was defined using ROC with sensitivity and specificity. P value <0,05 was considered statistically significant. According to the histopathology results, while the highest values were measured in the adenomyosis group, the lowest values were measured in the normal group. The success rate of separating normal myometrium and adenomyosis of elastographic measurements was 92%, sensitivity 93.1%, and specificity 82.1%. As a result, we that the use of ultrasonographic elastography in the diagnosis of adenomyosis is successful in distinguishing adenomyosis from normal myometrium, but not very successful in differentiating it from leiomyoma. Keywords: adenomyosis, shear wave elastography, benign uterine lesions