OP24.08: Combined treatment with the levonorgestrel‐releasing intrauterine device and ulipristal acetate in patients with uterine adenomyosis

Abstract

Objectives: To correlate the ultrasound appearance of highly vascularised uterine myomas to the histopathological diagnosis. Methods: This retrospective study included patients presenting with an ultrasound diagnosis of uterine myoma characterised by a circumferential and intralesional vascular pattern with a colour score assessment of 3 or 4, according to the Morphological Uterus Sonographic Assessment (MUSA). All the patients underwent myomectomy or hysterectomy after the ultrasound examination. The ultrasound appearance of the myomas was analysed and described using the terms and definitions of the MUSA paper. The echogenicity of each myoma, the presence of cystic areas and the total myoma volume were recorded. The ultrasound characteristics were compared with the histological diagnosis. Results: 52 patients were included in this study. Mean patient age was 42.5 years, 45 (86%) were in premenopause, 26 (50%) showed symptoms (pelvic pain, menorrhagia). At histological examination 25 (48%) myomas were compatible with a diagnosis of atypical leiomyoma (76% (19) hypercellular leiomyoma, 16% (4) myxoid leiomyoma, 8% (2) apoplectic leiomyoma). 25 (48%) were typical leiomyomas and 2 (4%) were adenomyomas. Cystic areas within the lesion were found in 32% (8/25) of atypical leiomyomas and in 16% (4/25) of typical leiomyomas. Conclusions: Ultrasound features such as circumferential and intralesional vascularity with a colour score of 3 or 4 and the presence of cystic areas may be predictive of atypical leiomyomas. Such features may be used to differentiate typical uterine myomas from the atypical variants in a pre-operative setting and to identify patients that may benefit from a conservative medical treatment rather than a radiological treatment. OP24.06Comparison of 2D and 3D transvaginal sonography to assess endometrial thickness