Khaladkar Sanjay M, Dhande Aryaman, Shah Rohan N, KirdatPatil Prajakta P
Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND.
Cureus. 2024 Nov 28;16(11):e74709. doi: 10.7759/cureus.74709. eCollection 2024 Nov.
Abnormal uterine bleeding (AUB) is a common gynecological condition that disrupts women's health due to irregularities in menstrual frequency, duration, and volume, often resulting in a significant impact on daily life and productivity. Accurate diagnosis of AUB is critical but complicated by its varied etiologies and presentations. Recent advancements in imaging techniques, particularly the Morphological Uterus Sonographic Assessment (MUSA), have enhanced the diagnostic precision of uterine pathologies such as fibroids and adenomyosis. MUSA combines gray-scale sonography, color Doppler, and three-dimensional ultrasound to evaluate uterine abnormalities with standardized terminology, ensuring diagnostic consistency. This study aimed to assess the efficacy of MUSA in diagnosing and managing AUB. A descriptive observational study was conducted on 50 patients at Dr. D. Y. Patil Medical College and Hospital, focusing on pre- and post-menopausal women with clinically symptomatic AUB. Patients underwent detailed ultrasonography, including both transabdominal and transvaginal scans, to evaluate uterine structures and correlate findings with histopathology. Results showed that 62% of patients had adenomyosis, while 38% had fibroids. MUSA effectively differentiated between the two conditions based on key ultrasound characteristics such as serosal contour, junctional zone, myometrial wall symmetry, and echogenicity. Adenomyosis cases showed significantly higher rates of heterogeneous echogenicity and asymmetrical myometrial walls compared to fibroids. Statistical analyses revealed high diagnostic sensitivity and specificity for both conditions, with an overall accuracy of 88.9% for adenomyosis and 94.1% for fibroids. The findings confirm the utility of MUSA in improving diagnostic accuracy and informing management strategies for AUB, particularly in complex cases. The study highlights MUSA as an indispensable tool for clinicians, facilitating enhanced patient outcomes through precise evaluation and treatment of uterine pathologies.
异常子宫出血（AUB）是一种常见的妇科疾病，由于月经频率、持续时间和经量的异常而扰乱女性健康，常常对日常生活和工作效率产生重大影响。准确诊断AUB至关重要，但因其病因和表现多样而变得复杂。成像技术的最新进展，尤其是子宫形态超声评估（MUSA），提高了子宫肌瘤和子宫腺肌病等子宫疾病的诊断准确性。MUSA结合了灰阶超声、彩色多普勒和三维超声，用标准化术语评估子宫异常，确保诊断的一致性。本研究旨在评估MUSA在诊断和管理AUB方面的疗效。在D.Y.帕蒂尔医学院和医院对50例患者进行了一项描述性观察研究，重点关注有临床症状的AUB的绝经前和绝经后女性。患者接受了详细的超声检查，包括经腹和经阴道扫描，以评估子宫结构并将检查结果与组织病理学相关联。结果显示，62%的患者患有子宫腺肌病，38%的患者患有子宫肌瘤。MUSA根据关键的超声特征，如浆膜轮廓、交界区、肌层壁对称性和回声性，有效地区分了这两种疾病。与子宫肌瘤相比，子宫腺肌病病例的回声不均匀和肌层壁不对称的发生率明显更高。统计分析显示这两种疾病的诊断敏感性和特异性都很高，子宫腺肌病的总体准确率为88.9%，子宫肌瘤为94.1%。这些发现证实了MUSA在提高诊断准确性和为AUB的管理策略提供信息方面的效用，特别是在复杂病例中。该研究强调MUSA是临床医生不可或缺的工具，通过对子宫疾病的精确评估和治疗，促进改善患者预后。
