Analysis of shear wave elastography and elastometry results in the endometrial pathology diagnosis in patients with secondary infertility

Abstract

Aim. To analyze the results of the application and to study the effectiveness of ultrasound shear wave elastography and elastometry in the endometrial pathology diagnosis in secondary infertility.

Methods. Multiparameter ultrasound with shear wave elastography and elastometry modes (Shear Wave Elastography) was performed in 146 women of reproductive age (Aixplorer scanner, Supersonic Imagine, France). The main group (N1) included 101 women with secondary infertility: 43 patients with tuberculous lesions of the uterus, 58 - with chronic endometritis without concomitant tuberculosis. The control group (N2) included 45 healthy women: 22 nulliparous women, 23 - parous women. Age of examined women ranged from 24 to 48 years, mean age in N1 group was 34.4±2.6 years, in N2 group - 33.9±2.9 years.

Results.. Depending on the nature of the pathology elastographic cards of examined women in the main group differed in color. Elastographic cards of blue-green range of low intensity dominated in patients with chronic endometritis. In patients with tuberculous lesions of the uterus unevenly colored, non-homogeneous, high intensity, from green to yellow and red in color-grade elastographic cards were determined. Endometrial stiffness values in patients with chronic endometritis and in tuberculous lesions of the endometrium (31.7±4.3 and 89.7±5.7 kPa, respectively) were significantly higher than that in healthy women (16.5±1.0 kPa, p

Conclusion. The presented analysis indicates the feasibility of the shear wave elastography and elastometry application in multiparameter ultrasound study of the uterus and adnexa in the diagnostic algorithm of patients with secondary infertility.

Keywords

ultrasound / shear wave elastography / endometrium / infertility / tuberculosis

References

[1] Диомидова В.Н., Захарова О.В., Петрова О.В. Эластография сдвиговой волной в оценке эндометрия и миометрия у здоровых женщин репродуктивного возраста. Ультразвуков. и функционал. диагностика. 2015; (5): 51-56.

[2] Диомидова В.Н., Захарова О.В., Петрова О.В. Применение технологии эластографии сдвиговой волной в диагностике туберкулёзного поражения матки у пациенток с вторичным бесплодием. Вопр. гинекол., акушер. и перинатол. 2015; 14 (5): 11-15.

[3] Каюкова С.И., Макаров О.В., Демихова О.В., Корнилова 3.X. Проблемы своевременной диагностики туберкулёза женских половых органов. Туберкулёз и болезни лёгких. 2011; (3): 49-51.

[4] Клинышкова Т.В. Женское бесплодие. Диагностика и лечение. Учебно-методическое пособие. Омск: ИПЦ ОмГМА. 2009; 52 с.

[5] Кульчавеня Е.В., Краснов В.А., Скорняков С.Н. и др. Современные тенденции эпидемической ситуации по внеторакальному туберкулёзу. Туберкулёз и болезни лёгких. 2013; (12): 34-38.

[6] Лечение женского и мужского бесплодия. Вспомогательные репродуктивные технологии. Под ред. В.И. Кулакова, Б.В. Леонова, Л.Н. Кузмичёва. М.: МИА. 2005; 592 с.

[7] Митьков В.В., Хуако С.А., Саркисов С.Э., Митькова М.Д. Возможности эластографии и эластометрии сдвиговой волны в диагностике аденомиоза. Ультразвуков. и функционал. диагностика. 2011; (6): 22-28.

[8] Митьков В.В., Хуако С.А., Цыганов С.Е. и др. Сравнительный анализ данных эластографии сдвиговой волной и результатов морфологического исследования тела матки (предварительные результаты). Ультразвуков. и функционал. диагностика. 2013; (5): 99-114.

[9] Тихомиров А.Л., Лубнин Д.М. Основы репродуктивной гинекологии. М.: Медпрактика-М. 2003; 200 с.

[10] Aliyu M.H., Aliyu S.H., Salihu H.M. Female genital tuberculosis: global review. Int. J. Ferti. Won. Med. 2004; 49 (3): 123-136.

[11] Carlson L.C., Feltovich H., Palmeri M.L. et al. Estimation of shear wave speed in the human uterine cervix. Ultrasound Obstet. Gynecol. 2014; 43 (4): 452-458. http://dx.doi.org/10.1002/uog.12555

[12] Gennisson J.L., Muller M., Gabor P. et al. Quantification of elasticity changes in the myometrium during labor using Supersonic Shear Imaging: a feasibility study. Ultrasonics. 2015; 56: 183-188. http://dx.doi.org/10.1016/j.ultras.2014.07.013

[13] Hernandez-Andrade E., Aurioles-Garibay A., Garcia M. et al. Effect of depth on shear-wave elastography estimated in the internal and external cervical os during pregnancy. J. Perinat. Med. 2014; 42 (5): 549-557. http://dx.doi.org/10.1515/jpm-2014-0073

[14] Mondal S.K., Dukka T.K. A ten year clinicopathological study of female genital tuberculosis and impact on fertility. JNMA J. Nepal. Med. Assoc. 2009; 48 (173): 52-57.

[15] Preis K., Zielinska K., Swiatkowska-Freund M. et al. The role of elastography in the differential diagnosis of endometrial pathologies - preliminary report. Ginekol. Pol. 2011; 82 (7): 494-497.

RIGHTS & PERMISSIONS

Diomidova V.N., Zakharova O.V., Spiridonova T.K., Petrova O.V.