Clinical­and­echographic feature of combination adenomyosis with the pathological processes of endometrium

Abstract

DOI: 10.52705/2788-6190-2025-02.1-15
УДК 618.14-031:611.664]-018-007.415-073.432.19-039

The objective: to find out clinical-and-echographic features and nosotropic mechanisms of combination of adenomyosis with the pathological processes of endometrium.
Materials and methods. In the real research were included 153 patients of adenomyosisом in combination with the pathological processes of endometrium. By the criterion of selection patients the set clinical diagnosis of adenomyosis appeared on the basis of careful analysis clinical-andanamnestic, instrumental-diagnostic and morphological information. In the cases when after complex clinical-instrumental and histological inspection the clinical diagnosis of adenomyosis caused doubts, this fact was the criterion of exception. Fact of combination of adenomyosis with a uterine fibroids by sizes 15 and more than weeks also was pregnancy the criterion of exception. On the basis of results of own research of 153 patients with the combined pathology of uterus (adenomyosis) and endometrium parted on groups: 1 group – «clean» adenomyosis (n = 40); 2 groups – adenomyosis and recurrent endometrial hyperplasia (n = 41); 3 groups – adenomyosis and endometrial atypia hyperplasia of (n = 42); 4 groups – adenomyosis and cancer of endometrium (n=30).
Results. Genetic inclination, state of relative or absolute hyperestrogenism as a result of ovarian hypofunction, metabolic syndrome, diseases of liver, chronic inflammatory diseases (genital and extragenital) over, contributory infringement to the decline of local and general immunity, which brings to local violation of support of constancy of cellular composition of tissue of uterus, change of reception of estrogen and progesterone, is the most meaningful factors of risk of development of hyperplastic processes of organs of reproduction.
Conclusions. Findings testify that the method of coloured Doppler hydrosonography allowed to complement information, got preliminary at an echography (transabdominal and transvaginal ultrasonic research, coloured Doppler mapping and impulsive Dopplermetry) as a result the number of indefinite, not clear, doubtful interpretations of diagnosis diminished for patients with combination of uterine fibroids and adenomyosis. During the conduct of echography, taking into account development of adenomyosis at the invasion of endometrium from a basale layer in a myometrium, and also taking into account the structural changes adjoining to endometrium areas of myometrium verified at morphology, the special attention was spared to the scan-out of the so-called «boundary» zone. The followings signs of echo appear during the detailed visualization of this zone: an unclear limit is between a myometrium and endometrium; uneven bulge of «boundary» zone; a heterogeneous structure of limit is a «endometrium-myometrium», where the hyperechogenic including appear as shallow, more frequent than the rounded or linear structures.