P29.02: Doppler sonography peculiarities of uterus tissual blood flow of patients with adenomyosis treated with steroid hormonal therapy

Abstract

Poster abstracts deep endometriosis were submitted to US and MR so as to correlate the findings. In both methods the sizes, location and the extension of the lesions were analyzed. Results: US detected a total of 40 lesions meanwhile MR detected 53 lesions in the pelvis. The comparative study between US and MR has not shown significant statistical difference (P > 0, 19% and P > 0, 14%, respectively). Taking into consideration rectosigmoid junction, MR has detected one lesion (5.6%) meanwhile US has indicated four lesions (22.2%). In the rectum lesions, US has detected eight (44.4%) and MR detected seven lesions (38.9%). Conclusions: US presented better results in the rectosigmoid junction and in the rectum; however it has detected a smaller number of lesions in the pelvis. In the global comparative analyses between US and MR in the detection of the lesions, there was no significant statistical difference.Supporting information can be found in the online version of this abstract. Objectives: To research the peculiarities of uterus tissual blood flow during steroid therapy of adenomyosis. Methods: 66 patients with adenomyosis, diagnosed according to clinical symptoms, transvaginal ultrasonography with color Doppler imaging (CDI) and loop biopsy of myometrium, were treated with combination of 30 mkg of ethinylestradiol and 2 mg of dienogest for 3 months daily and then for 9 months under contraception regimen, the menstrual blood volume, dysmenorrhea, the quantity of blood flow loci in myometrium were meanwhile observed. The patients were divided in two groups according to treatment results: effective -60, ineffective -6. Results: In the first 6 months of treatment, the menstrual blood volume was reduced significantly (P < 0.01) in both groups, and dysmenorrhea was obviously relieved. According to the data of CDI the quantity of color loci in middle and internal layers of myometrium per unit area during the treatment in the first group was reduced by the 3 month (P < 0.01) and didn't change during the treatment and for 3 months after cessation of therapy. In the second group recurrences of haemorrhage and/or dysmenorrhea served as indications for surgical treatment in 2 cases 8-10 months since the beginning of treatment, in 4 cases in 3 months after the cessation. In this group the reduction of myometrium vascularisation level wasn't registered in 5 cases in the whole course of observation. The difference in quantity of blood flow loci in 3 and 6 months after the beginning of the treatment between groups was significant (P < 0.05). Conclusions: Continuously high level of myometrium vascularisation according CDI data can serve as a predictor of ineffectiveness of steroid therapy of patients with adenomyosis.

Ultrasound Examination Possibilities in Adenomyosis Diagnostics in Patients With Reproductive Loss

“…Известно, что у пациенток с аденомиозом с проявлениями функциональной активности заболевания (гиперполименорея, перименструальные кровомазания, тазовые боли, диспареуния) по данным цветового допплеровского картирования имеется диффузное усиление кровотока в зонах расположения гетеротопий в миометрии [12,13].…”