Sonographic 3D Features Correlated to Uterine Pathological Issues

Abstract

Background:Adenomyosis is a frequent gynecological disease of unknown etiology causing menstrual pain disorders and pelvic congestion, that definite histopathological based diagnosis of adenomyosis relies on the presence of endometrial glands and stroma within the myometrial tissue, junctional zone assessed sonographically could elucidate the nature of disease progressive pathological changes. Aim: To investigate the value and usefulness of Junctional Zone indices in suspicion and diagnosis of adenomyosis disease in correlation to histopathological findings. Methodology: A clinical research trial conducted on 200 research study subjects scheduled for hysterectomy procedure due to abnormal uterine bleeding and/or dysmenorrhea unresponsive to medical treatment performed at Ain Shams University maternity hospital from January 2018 till March2019, all research study subjects have undergone two-and three-dimensional transvaginal sonography before the day of surgery. Results: There was statistically significant difference between research groups (Adenomyosis of the inner myometrium, Serrated junctional zone, Linear junctional zone,) as regards 2 D features anechoic lacunae, asymmetric corpus myometrium, myometrial cysts, fan shaped shadowing, mean number of 2D features (p values <0.001), concerning 3 D features Mean JZmax, Mean JZdiff, JZ interruption, Sub endometrial lines and buds, mean number of 3D features (p values<0.001). Conclusions: Junctional zone changes could be denoting early phases of adenomyosis disease development furthermore the 3 D sonographic features implemented were considered and shown to be more valuable in elucidating the pathological changes confirmed by histopathological examination.