Reliable diagnosis of adenomyosis and uterine fibroids using transvaginal ultrasonography with strain elastography

Dr. Surbhi, Surbhi Gahlot, Sachin Khanduri, Vaibhav Pathak, Ashkrit Gupta, Zaara Khan, Rohit, Somya Singhal, Avani Kanojia
In: International Journal of Radiology and Diagnostic Imaging · 2023 · vol. 6(3) , pp. 17–21 · doi:10.33545/26644436.2023.v6.i3a.338 · W4385498708
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Transvaginal ultrasonography with strain elastography accurately differentiated adenomyosis and uterine fibroids from normal myometrium, with distinct elastographic patterns compared to MRI diagnoses.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This prospective study evaluated diagnostic accuracy of transvaginal ultrasonography combined with strain-ratio elastography (SRE) for adenomyosis and uterine fibroids in 84 women with suspected disease on transabdominal sonography, with MRI as the comparison standard. Strain values were computed from two adjacent ROIs (ROI A in the suspected adenomyosis/fibroid area and ROI B in normal myometrium) and analyzed using the strain ratio (B/A), alongside qualitative elastographic color pattern observations. Median strain ratios differed significantly between fibroids and adenomyosis (1.85 for fibroids vs 0.54 for adenomyosis, p<0.001), and elastography-based diagnoses showed strong agreement with MRI-based diagnoses. The paper’s main limitation as stated in the abstract is that results are based on a relatively small, single prospective cohort and provide limited detail on diagnostic performance metrics beyond agreement. This paper is centrally about endometriosis and/or adenomyosis—specifically adenomyosis—using transvaginal strain elastography compared against MRI for reliable diagnosis.

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Abstract

Introduction: Special types of benign gynecological conditions such as uterine fibroids and adenomyosis are very common these days. So our main objective is to assess the diagnostic accuracy of transvaginal ultrasonography combined with strain-ratio elastography (SRE) in diagnosing Adenomyosis and Uterine Fibroids and to compare the results with magnetic resonance imaging (MRI)-based diagnoses.Material and Methods: In a prospective study was conducted on 84 women with suspected adenomyosis or fibroid on transabdominal sonography. These patients underwent transvaginal ultrasonography combined with strain-ratio elastography. This was followed by MRI imaging of the same patients. Computation of strain values at two ROIs placed next toeach other in a uterine adenomyosis or fibroid (ROI A) and the normal myometrium (ROI B). The strain ratio (B/A) was calculated and stored. These elastography based diagnoses were compared with MRI diagnoses.Results: The myometrium was uniform in color, with a main color of green, indicating stiffer tissue. Adenomyosis and fibroids had dissimilar attributes with respect to elastographic and color patterns. In general, fibroids were darker blue and adenomyosis was yellowish to red in color. The median strain ratio was significantly (p
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Abstract

Introduction: Special types of benign gynecological conditions such as uterine fibroids and adenomyosis are very common these days. So our main objective is to assess the diagnostic accuracy of transvaginal ultrasonography combined with strain-ratio elastography (SRE) in diagnosing Adenomyosis and Uterine Fibroids and to compare the results with magnetic resonance imaging (MRI)-based diagnoses.

Material and methods

In a prospective study was conducted on 84 women with suspected adenomyosis or fibroid on transabdominal sonography. These patients underwent transvaginal ultrasonography combined with strain-ratio elastography. This was followed by MRI imaging of the same patients. Computation of strain values at two ROIs placed next toeach other in a uterine adenomyosis or fibroid (ROI A) and the normal myometrium (ROI B). The strain ratio (B/A) was calculated and stored. These elastography based diagnoses were compared with MRI diagnoses.

Results

The myometrium was uniform in color, with a main color of green, indicating stiffer tissue. Adenomyosis and fibroids had dissimilar attributes with respect to elastographic and color patterns. In general, fibroids were darker blue and adenomyosis was yellowish to red in color. The median strain ratio was significantly (p<0.001) different between the uterine fibroid and adenomyosis. Median strain ratio were 1.85 and 0.54 for fibroids and adenomyosis respectively. The diagnosis of adenomyosis and fibroids using elastography shows harmonious results with MRI-based diagnosis.

Conclusions

The chromic data makes it possible for detecting uterine fibroid and adenomyosis and assists to detect both focal findings, in addition, the strain ratio allows for quantification of the stiffness factor. The quantitative data from the strain ratio is more useful than the qualitative color-coded images. Elastography is capable of recognizing discerning attributes of fibroids and adenomyosis. Elastography based conclusions are in excellent agreement with that of MRI. With easier and cheaper availability of the sonographic setup and reduced scanning time as compared to MRI, transvaginal ultrasonography in conjugation with strain ratio can be used to make a reliable diagnosis of fibroid or adenomyosis. Pages: 17-21 | Views: 3464 | Downloads: 2188 How to cite this article: Dr. Sachin Khanduri, Dr. Vaibhav Pathak, Dr. Surbhi, Dr. Ashkrit Gupta, Dr. Sachin Goswami, Dr. Kunal Dwari, Dr. Vinima Jaiswal, Dr. Somya Singhal. Reliable diagnosis of adenomyosis and uterine fibroids using transvaginal ultrasonography with strain elastography. Int J Radiol Diagn Imaging 2023;6(3):17-21. DOI: 10.33545/26644436.2023.v6.i3a.338

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Condition tags

adenomyosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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