Possibility of color doppler in predicting of steroid therapy efficiency in patients with adenomyosis

А. В. Поморцев
2014 · doi:10.1594/ecr2014/c-1959 · W2526685370
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The authors investigated whether color Doppler ultrasound could predict the efficiency of steroid therapy in patients diagnosed with adenomyosis.

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This study evaluated whether color Doppler ultrasound could predict the efficacy of steroid therapy in 80 patients with adenomyosis. Researchers measured blood flow loci in the myometrium before and during twelve months of treatment with ethinylestradiol and dienogest, observing that successful responders showed a significant decrease in vascularization within three months. In contrast, patients who required surgical intervention due to recurrent symptoms maintained persistent high vascularization levels throughout the observation period. The authors concluded that sustained high microvascular density on Doppler imaging serves as a reliable predictor for failed medical management. This paper is centrally about adenomyosis — specifically using Doppler sonography to assess hemodynamic changes and predict therapeutic outcomes in this condition.

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Abstract

Poster: ECR 2014 / C-1959 / Possibility of color doppler in predicting of steroid therapy efficiency in patients with adenomyosis by: K. Lobanov, A. Pomortsev, T. Makukhina, V. Vidyaeva; Krasnodar/RU
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Keywords

Outcomes, Efficacy studies, Ultrasound-Colour Doppler, Ultrasound, Genital / Reproductive system female Authors: K. Lobanov, A. Pomortsev, T. Makukhina, V. Vidyaeva; Krasnodar/RU DOI: 10.1594/ecr2014/C-1959 Aims and objectives To investigate bloodflow changes in myometrium during steroid therapy of adenomyosis.

Methods

and materials 80 patients with adenomyosis diagnosed according to clinical symptoms, transvaginal sonography with color Doppler ultrasound imaging (CD) and loop biopsy of myometrium were treated with standard steroid therapy (30 mkg of ethinylestradiol and 2 mg of dienogest) for 12 months. The number of bloodflow loci was evaluated in the standard saggital uterus section with minimal sensitivity setting of Doppler system. The saggital section area was calculated by manual operation excluding endometrium area. After that the average number of bloodflow loci per 1 square sm was...

Results

Before steroid therapy a significant increase ofbloodflow loci number (LN) according to CD was observed in the patients with adenomyosis (р<0,01). The LN in the first group decreased in 3 months (р<0,01) and no significant difference of vascularisation with the control group was found. Further LN in this group didn’t change during observation. In the second group recurrence of bleeding and/or dysmenorrhea served as indications for surgical treatment from 8 to 15 months since the beginning of treatment. In this group there was no LN...

Conclusion

Persistent high vascularisation level of miometrium according to CD may be used as a predictor of failed steroid therapy for patients with adenomyosis. Personal information Pomortsev Alexey Victorovich - professor, Head of Radiology Department of Kuban State Medical University. Krasnodar,[email protected]

References

Schindl M., Birner P., Obermair A., Kiesel L., Wenzl R. Increased microvessel density in adenomyosis uteri // Fertil. steril. – 2001. – V. 75. № 1. – Р. 131–135. Makukhina T.B., Pomortsev A.V., Lobanov K.A. Doppler sonography peculiarities of uterus tissual blood flow of patients with adenomyosis treated with steroid hormonal therapy. Ultrasound in obstetrics and gynecology. – Oct. 2011, Vol. 38, suppl. 1. – P. 265. Mabrouk M., Frasca C., Geraci E., Montanari G., Ferrini G., Raimondo D., Alvisi S., Paradisi R., Villa G.,...

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Condition tags

adenomyosis

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