Application of elastography to diagnose adenomyosis and evaluate the degree of dysmenorrhea: a prospective observational study

Reproductive Biology and Endocrinology

Research

Hao Sun¹  Zangyu Pan¹  Xinyu Wang¹  Qianhui Ren²  Xue Jiao³  Wang Guoyun⁴  Ming Yuan⁴  Xiangyi Dong⁵  Guowei Tao⁵ 

[1] Cheeloo College of Medicine, Shandong University, Jinan, China;Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, 250021, Jinan, Shandong, China;Cheeloo College of Medicine, Shandong University, Jinan, China;Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, 250021, Jinan, Shandong, China;Cheeloo College of Medicine, Shandong University, Jinan, China;JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, Shandong Province, China;Gynecology Laboratory, Shandong Provincial Hospital, Jinan, Shandong Province, China;Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, China;Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, 250021, Jinan, Shandong, China;JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, Shandong Province, China;Gynecology Laboratory, Shandong Provincial Hospital, Jinan, Shandong Province, China;Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, China;Department of Ultrasonic Medicine, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, 250012, Jinan, China;

关键词: Adenomyosis;    Diagnosis;    Dysmenorrhea;    Elastography;    Fibrosis;   

DOI  :  10.1186/s12958-023-01145-y

 received in 2023-08-24, accepted in 2023-09-24,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTo determine whether there is a correlation between stiffness measured by strain elastography and the severity of dysmenorrhea and to determine the value of elastography in evaluating severe dysmenorrhea in patients with adenomyosis.MethodsThe correlation between tissue stiffness and dysmenorrhea was analyzed by performing elastography on premenopausal women diagnosed with adenomyosis. Expression levels of transforming growth factor-β (TGF-β), α-smooth muscle actin (α-SMA), and protein gene product 9.5 (PGP9.5) were detected by immunohistochemistry; the correlation of TGF-β and α-SMA levels with the tissue stiffness and the degree of fibrosis was further analyzed. Also, the relationship of the PGP9.5 expression level with the tissue stiffness and degree of dysmenorrhea was determined.ResultsThe degree of dysmenorrhea was significantly positively correlated with lesion stiffness in patients with adenomyosis but not with the uterine or lesion volume. The cutoff for the strain ratio was > 1.36 between the adenomyosis and control groups, with an area under the curve (AUC) of 0.987. For severe dysmenorrhea, the cutoff for the strain ratio was > 1.65 in patients with adenomyosis, with an AUC of 0.849. TGF-β, α-SMA, and PGP9.5 expression levels were higher in adenomyotic lesions than in the endometrium of the adenomyosis and control groups. Both TGF-β and α-SMA levels were positively correlated with the tissue stiffness and degree of fibrosis. Additionally, the expression level of PGP9.5 showed a positive correlation with the tissue stiffness and degree of dysmenorrhea.ConclusionsElastography can be used to evaluate the degree of dysmenorrhea; the greater the tissue stiffness, the greater the degree of dysmenorrhea. In addition, elastography performed well in the diagnosis of adenomyosis and the evaluation of severe dysmenorrhea in patients with adenomyosis.

【 授权许可】

CC BY   
© The Author(s) 2023

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