Sonoelastography in differential diagnosis of pathological processes of the myometrium (literature review)

Abstract

Background. Intrauterine pathological processes, the most common medical conditions of which are leiomyoma, adenomyosis and infiltrative adenocarci- noma, currently represent a quite prevailing group of gynecological pathology, dangerous due to the potential of malignancy and recurrence. The development of an integrated non-invasive diagnostic approach that takes into account risk factors, symptoms, clinical examination and imaging, makes it possible to make an accurate diagnosis, which is essential to determine therapeutic strategy. Рurpose – to carry out a systematic analysis of the uptodate scientific literature regarding the use of imaging methods in diagnosis of pathological processes of the myometrium and determine the main directions of their development in these pathologies. Materials and methods. The material for the study were publications and results of clinical trials found in Scopus, Web of Science Core Collection and PubMed databases for the period from 2013 to 2020 based on the keywords like “adeno- myosis”, “leiomyoma”, “adenocarcinoma”, “sonography”, “sonoelastography”. Results and discussion. The complexity of diagnosing myometrial neoplasms, especially in case of combinations, initiates the search for new algorithms for diagnosing pathological processes of the myometrium, the purpose of which, ultimately, is to determine personalized strategy of treatment of female patients. According to the literature, recently sonoelastography potential has been increasingly used in diagnosis of the reproductive system diseases and assessment of the functional state of uterine tissues, contributing to differential diagnosis, monitoring and treatment of these diseases. Conclusions. Thus, there is a limited number of studies on the diagnosis of myometrium pathology along with insufficient general standards of technique for conducting and interpreting the findings of sonoelastography in the reproductive system pathology. Adding sonoelastography data to sonographic images in B-mode is useful for differentiating leiomyoma, adenomyosis, and normal uterus, which is reflected in increased accuracy and diagnostic consistency. Sonoelastography potential consists in increasing the accuracy of diagnosis, safety and availability of the method, its low cost. This contributes to the possibility of wider implementation of the technique in clinical practice in order to obtain additional diagnostic information.