Abstract
Background. Uterine leiomyoma and endometriosis are common gynecological diseases of women in childbearing potential. This fact necessitates developing an optimal protocol for examination of patients in order to implement an individual approach to treatment. Diagnosis of mixed forms of pathological myometrium conditions causes some difficulties. Elastography technique makes it possible to assess the density of the myometrium, which may be essential for differentiating the diagnosis of leiomyoma and adenomyosis in mixed forms.
 Рurpose – to ascertain the potential of transvaginal ultrasound along with compression sonoelastography to determine the deformation coefficient in differential diagnosis of various pathological myometrium conditions.
 Materials and methods. The paper presents the analysis of elastographic findings of the uterus in 155 women obtained via compression sonoelastography performed by means of HITACHI AVIUS device. Patients were divided into 4 groups: control, women with uterine leiomyoma, uterine adenomyosis, with combined leiomyoma and adenomyosis. The transabdominal/ transvaginal ultrasound findings were confirmed by histopathological examination. The standard point scale was used to determine the deformation coefficient.
 Results. Elastographic characteristics were assessed in accordance with sonoelastography findings, i. e. deformation coefficients common in leiomyoma and adenomyosis. The maximum values of the deformation coefficient were obtained in leiomyoma (in an amount of 2 to 6.0 units). In case of diffuse or focal adenomyosis, the deformation coefficient was in an amount of 0.5 to 1.5 units indicating high myometrial elasticity vs the unchanged myometrium. For its part, in Group I (control), the deformation coefficient ranged from 1 to 1.7 units. High myometrial elasticity in adenomyosis vs the unchanged myometrium as well low elasticity or high density of the myometrium in leiomyoma were observed.
 Conclusions. The deformation coefficients in patients with leiomyoma and adenomyosis and unchanged myometrium were obtained via ultrasound with compression sonoelastography and they made it possible to determine the degree of elasticity of the myometrium and its changes in the relevant pathology. Elastography is capable of identifying clear distinctive features of leiomyoma and adenomyosis. The coincidence of the diagnosis of adenomyosis based on elastography and histology is significant, but not optimal. The unchanged myometrium has a certain elasticity, which can be equated to a numerical value, i. e. the deformation coefficient, and this param changes in case of leiomyoma or adenomyosis, which makes it possible to differentiate these pathological conditions of the myometrium.
Highlights
The prevailing benign tumor of the female reproductive system occurring in 20–50 % cases and tending to affect the young population is uterine leiomyoma [1]
Elastographic characteristics were assessed in accordance with е-mail: diagnost-uzi@ukr.net sonoelastography findings, i. e. deformation coefficients common in leiomyoma and adenomyosis
S., 2021 case of diffuse or focal adenomyosis, the deformation coefficient was in an amount of 0.5 to 1.5 units indicating high myometrial elasticity vs the unchanged myometrium
Summary
The prevailing benign tumor of the female reproductive system occurring in 20–50 % cases and tending to affect the young population is uterine leiomyoma [1]. Endometriosis ranks third after inflammatory diseases and uterine fibroids. This disease is diagnosed in 21–40 % of women with infertility, in 70–90 % it is the cause of chronic pelvic pain. Under such conditions, genital endometriosis is 92–94 %, extragenital one is 6–8 % [3]. Some patients have asymptomatic endometriosis, which can be accidentally detected via laparoscopy [4]. There are certain difficulties when diagnosing endometriosis, especially its initial (small) forms, which are poorly detected these days [5]
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