The Value Of Transvaginal Ultrasound And Elastosonography In The Diagnosis Of Myomass And Adenomyoma

Objective: To explor the value of transvaginal ultrasound and elast osonography in the diagnosis of myomass and adenomyoma. Apply Scor ing Method and Strain Histogram to analysis the elastic-images of myo mass and adenomyoma. Comparing the value of these methods in the d iagnosis and differentiation of myomass and adenomyoma.Method:1 Object of study: 96 patients that with myomass or adenomyoma had been selected. The patients were divided into two groups:myomass group, 57 cases, the average age was 42.81±7.36; adenomyoma group, 39 cases, the average age was 43.79±4.95. Another 19 cases were selected as normal control group, the average age was 31.73±7.36. All of them were examed by transvaginal ultrasound and elastosonography.2 Instruments and Method: The machine used in the program is Hitachi Ascendus Color Ultrasonic diagnostic instrument which is equipped with intralumen probe and the function of real-time elastosonography. The frequency of the probe is 4-8MHZ. The uterus and accessories were routinely scaned. When the myomass or adenomyoma were founded, the size of mass were measured, its hemodynamic and elastosonography changes had also been observed. Two methods were used to analysis the elastosonography of the masses. The first mehod is Scoring Method, that is based on the improved Scoring Method proposed by booming Luo, and the elastosonography had been blindly scored by two ultrasound doctors. The second one is the Strain Histogram. When the elastosonography was stabled, the center and entire of the masses were analysed by this software. The result is 11 parameters that MEAN?SD?AREA%?COMP?KURT?SKEW?CONT?ENT?IDM?ASM?CORR.3 The Statistical Analysis: If the 11 parameters meet the normality and homogeneity of variance, use One-Way ANOVA or T-test, nor use t he Multiple Independent Samples Nonparametric tests, P<0.05. Use the two independent samples nonparametric tests to analysis the Scoring Me thod, P<0.05.Resluts: 1 B-Mode Ultrasonography of myomass and adenomyoma:Myomass is commonly of low echo and has clear boundaries, sometime s swirling can be found in internal, pseudo-capsule can be observed sur rounding the mass. Adenomyoma's echo is usually heterogeneous, no cl ear boundaries and pseudo-capsule generally. Meanwhile, anechoic cysts can be found in the uterine wall. 2 Elastosonography of myomass and adenomyoma: the main color of myomass is blue and green, sometimes the red can be seen in the internal and circum, the color of the pseudo-capsule is red. The elastic image of Myomass corresponded to its B-M ode Ultrasonography well. Such as low echo of B-mode ultrasound mat ches blue color of elastosonography, medium echo matches blue, hypere cho matches red or yellow. The main color of adenomyoma is yellow a nd green. Most adenomyoma internal markings are irregular red flakes. Red pseudo-capsule can not be founded in adenomyomas because they don not have obvious boundary in B-mode ultrasound. 3 The results of the Strain Histogram: 1) The comparison between normal group?myom ass?and adenomyoma, the parameters for(P < 0.05) is MEAN?ARE A%?COMP?SKEW?CONT?ENT?IDM?CORR; 2) The comparison between the center of normal group?myomass?and adenomyoma, the p arameters for(P < 0.05) is MEAN?SD?AREA%?COMP?KURT?S KEW?CONT?ENT?IDM?CORR; 3) The comparison between the ce nter and entirety of myomass, the parameters for(P < 0.05) is MEAN?SD?AREA%?COMP?KURT?SKEW?CONT?ENT?IDM?ASM?C ORR; 4) The comparison between the center and entirety of adenomyo ma,the parameters for(P < 0.05) is MEAN?SD?AREA%?COMP?K URT?SKEW?CONT?ENT?IDM?CORR; 5) The comparison of the entiret y between myomass and adenomyoma, the parameters for(P < 0.05) is MEAN?AREA%?COMP?KURT?SKEW?CONT?ENT?IDM; 6) Th e comparison of the center between myomass and adenomyoma, the par ameters for(P < 0.05) is MEAN?SD?AREA%?COMP?KURT?SKE W?CONT?ENT?IDM; 7) The comparison between near the probe an d away from it in the normal group's uterine wall, the parameters for(P < 0.05) is COMP?MEAN.Conclusion: Ultrasound elasticity Scoring Method and elastosonogra phy Strain Histogram has certain value in the differential diagnosis of myomass and adenomyoma. The value of the differential diagnosis in th e two diseases can be improved by combining B-mode Transvaginal Ult rasound with elastosonography. But Elastosonography has obvious restric tion on large volume masses.