Background: Adenomyosis is characterised as benign endometrial invasion into the myometrium in endometrial glands and stroma surrounded by hypertrophic and hyperplastic smooth muscles. To summarise the uterine adenomyosis diagnostic modalities that could be used: clinical diagnosis, TVS, MRI, elastosonography, and the gold standard method, which is pathological investigation of hysterectomy samples.
Objective: This study aims to assess the accuracy of shear wave elastography in the diagnosis of adenomyosis compared to MRI.
Patients and methods: This is a pilot study conducted on 118 premenopausal patients planned for total hysterectomy at Al-Hussein Obstetrics and Gynecology Hospital, due to benign pelvic conditions.
Results: Twenty seven patients (54%) had histopathological diagnosis of uterine adenomyosis. The clinical manifestations that may be related to uterine adenomyosis were AUB (43%) and chronic pelvic pain (44%). The specificities of TVS, shear wave elastography (SWE) and MRI are comparable, while, the sensitivity of TVS is non-significantly less than those of either SWE or MRI. The sensitivity of SWE and MRI were comparable. This study shows that the prevalence of uterine adenomyosis is 54% in premenopausal patients treated by hysterectomy for some gynecological disorders. This prevalence is overestimation because of indication- bias and because women who need treatment by hysterectomy do not represent the general women population.
Conclusion: Shear Wave Elastography is a new diagnostic approach that analyses the mechanical properties of tissue. It is non-invasive, simple to conduct and interpret, does not considerably increase TVS examination time, and has a short learning curve to become experienced in the operation.