TAS or TVS in a presumed case of adenomyosis??Ans:- Two-dimensional (2D)
transabdominal USG may reveal uterine enlargement or asymmetric thickening of
the anterior and posterior myometrial walls. However, transabdominal USG is often not accurate enough in
diagnosing adenomyosis as it fails to provide sufficient image resolution for
visualization of the myometrium. Therefore, 2D transvaginal USG is often the
first-line investigation.
Transvaginal USG had a sensitivity of 80–86%, specificity of 50–96%, and
an overall accuracy of 68–86% in diagnosing diffuse adenomyosis .
USG features of adenomyosis include the presence of three or more
sonographic criteria: 1) heterogeneity, 2) increased echogenicity, 3) decreased
echogenicity, and 4) anechoic lacunae or 5) myometrial cysts . How to differentiate from myoma?? Ans:-In
contrast to uterine fibroids, adenomyoma has a more elliptical shaped lesion with poorly defined borders, no calcifications, or edge shadowing.
In doubtful cases, Doppler
sonography may be helpful in that blood vessels in the case of adenomyoma
usually follow their normal vertical course in the myometrial areas while in
the case of uterine fibroid, blood vessels are usually located in the periphery
.But the problem of USG is that sonographic diagnosis of adenomyosis is not
always easy though the consensus
statement and recommendation published by the MUSA (Morphological Uterus Sonographic
Assessment) group on how sonographic features of adenomyosis should be
described and measured should help to improve the diagnostic accuracy
No comments:
Post a Comment