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Subject Area

Obstetrics and Gynecology

Article Type

Original Study

Abstract

Objective The purpose of this study is to evaluate the importance of three-dimensional (3D) power Doppler ultrasound (US) in the diagnosis and differentiation of leiomyoma and adenomyosis of the uterus. Background The clinical presentation of adenomyosis and leiomyoma overlaps. The 3/4D US imaging has been currently able to produce female pelvis images that are comparable with magnetic resonance imaging and computerized tomography images in both quality and orientation, with the benefit of being without radiation and low cost. Patients and methods This study included female patients clinically diagnosed as having uterine leiomyoma and/or adenomyosis and were indicated for hysterectomy. By Doppler velocimetry with the use 3D power Doppler, the waveforms of the ascending main branch of the uterine artery were obtained on both sides of the cervix. Calculation of the resistance index (RI) and pulsatility index (PI) was done in an automatic manner. The averages of arteries on both sides were taken. Results The vascularity of most of the leiomyoma lesions was peripheral and of all of the adenomyosis lesions was central. The adenomyosis group showed significantly decreased vascular index, flow index, and vascular-flow index mean values (P < 0.01), significantly increased uterine artery RI mean values (P < 0.05), and highly significantly increased PI values (P < 0.01). Conclusion Three-dimensional US imaging with power Doppler can increase the accuracy of differentiation between leiomyoma and adenomyosis cases. Significant differences were noted in the vascularity site and Doppler indices.

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