METHODS: This was a prospective observational study. Only reproductive age women who underwent standardized transvaginal ultrasound examination were included. The diagnosis of adenomyosis was based on sonographic features proposed by Morphological Uterus Sonographic Assessment (MUSA) group. Pictorial blood loss assessment chart (PBAC) and numerical rating scale (NRS) were respectively used for the evaluation of menstrual bleeding and pain.
RESULTS: Fifty-three women were recruited. Adenomyosis group consisted of 33 (62.3%) representative cases, whereas control group consisted of 20 (37.7%). Women with adenomyosis experienced significantly heavier menstrual bleeding (p = 0.008) and more painful menstrual periods (p = 0.003). Significant positive correlation between the number of sonographic adenomyosis features and both PBAC (r = 0.613, p < 0.001) and NRS scores (r = 0.402, p = 0.022) was found. PBAC score was significantly higher if either fan-shaped shadowing (r = 0.548, p = 0.001), interrupted junctional zone (JZ) (r = 0.548, p = 0.001) or globular uterus (r = 0.445, p = 0.011) was detected. Interrupted JZ (r = 0.440, p = 0.012) was associated with higher NRS score. Significant positive correlation between PBAC score and adenomyosis spread in uterine layers (r = 0.495, p = 0.004) was established.
CONCLUSIONS: Certain sonographic features of adenomyosis and assessment of its involvement in uterine layers may predict the severity of adenomyosis symptoms.
方法:这是一项前瞻性观察性研究。仅包括接受标准化经阴道超声检查的育龄女性。子宫腺肌病的诊断基于子宫形态超声评估(MUSA)组提出的超声特征。分别采用图形失血评估图(PBAC)和数字评定量表(NRS)评价经血出血和疼痛。
结果:招募了53名女性。子宫腺肌病组包括33例(62.3%)代表病例,而对照组为20人(37.7%)。患有子宫腺肌病的女性经历了明显加重的月经出血(p=0.008)和更痛苦的月经期(p=0.003)。发现超声检查子宫腺肌病特征的数量与PBAC(r=0.613,p<0.001)和NRS评分(r=0.402,p=0.022)之间存在显着正相关。如果采用扇形阴影(r=0.548,p=0.001),则PBAC得分明显更高。检测到间断性交界区(JZ)(r=0.548,p=0.001)或球状子宫(r=0.445,p=0.011)。中断的JZ(r=0.440,p=0.012)与较高的NRS评分相关。建立了PBAC评分与子宫腺肌病扩散之间的显着正相关(r=0.495,p=0.004)。
结论:子宫腺肌病的某些超声特征及其在子宫层受累情况的评估可以预测子宫腺肌病症状的严重程度。