ROLE OF ULTRASOUND WITH DOPPLER IN DIFFERENTIATING CLINICALLY SUSPECTED CASES OF LEIOMYOMA AND ADENOMYOSIS OF UTERUS

Abnormal uterine bleeding (AUB) is a common problem among women in the reproductive age group.1 It accounts for approximately 70% of the pathology in perimenopausal and post-menopausal women. AUB may occur because of hormonal imbalances or as a result of benign or malignant lesions.2
Benign myometrial lesions are common in women of reproductive age and can cause significant morbidity.3 The most common causes of uterine bleeding are adenomyosis and uterine leiomyoma. Leiomyomas are benign masses of uterine smooth muscles that can be surgically removed. Adenomyosis is an ill-defined lesion in which endometrial glands and stroma are interspersed with the myometrium, making complete removal through surgery challenging.4 Therefore, accurate preoperative diagnosis of these two conditions is critical. Imaging techniques play a crucial role in distinguishing leiomyomas from adenomyosis.
Histopathology, considered a corner stone in confirming the diagnosis, remains a gold standard.4
Transabdominal/transvaginal sonography is often performed and is planned as a first line imaging modality . The ability to globally visualise the pelvic structures and organs combined with colour Doppler greatly enhances diagnostic ability.5
This study aimed to differentiate clinically suspected cases of uterine Leiomyoma and Adenomyosis using grey-scale 2D ultrasonography with color Doppler to determine its accuracy and confirm histopathological findings .
Owing to similar clinical signs and symptoms, misdiagnosing one in favour of the other is not uncommon. The organic cause responsible for menstrual disorders should be ruled out to provide a final cure for a broad range of gynecological diseases and preoperative diagnosis of these two conditions is vital for patients wishing to retain their fertility.