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Article
Role of Diffusion Weighted Imaging (DWI) of MRI Study in Differentiation Between Adenomyosis and Fibroids of the Uterus in Al-Hilla Teaching Hospital

Authors: Kassim Amir Hadi Taj-Aldean --- Shaimaa Jassim Bader
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 4 Pages: 606 -615
Publisher: Babylon University جامعة بابل

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Abstract

The uterine fibroid is most common solid uterine tumour , it is single or multiple benign neoplasm and present in 20-40% of women in productive age. There are several factors that are attributed to underlie the incidence and development of these common tumors, but this further corroborates their relatively unknown etiology. The most likely presentation of fibroids is by their effect on pelvic pressure symptoms or the woman’s menstrual cycle .Adenomyosis of the uterus is benign uterine pathology. It is thought by many to be on the spectrum of endometriosis, with ectopic endometrial glandular tissue in the myometrium. Adenomyosis may present with dysmenorrhea and menorrhagia. Ultrasound and MRI are imaging modalities that may show characteristic findings. Diffusion weighted image in MRI has been applied to evaluate the intracranial lesion ,but technical advancement make it possible to use in extra cranial sites. The aim of this study was to assess the differences, if any, in the apparent diffusion coefficient (ADC) values of adenomyosis and fibroids. Methods and Material Total patient of sample study 56 ,Patients (n= 25) diagnosed by ultrasound as uterine fibroids and (n=31) as adenomyosis, who underwent pelvic MR imaging with DWI, were included in this cross section study. DWI was achieved with using a 1.5 T scanner , different b factors of ( 0, 400, and 600 s/mm) and ADC region of interest(ROI) size were located over an area of Adenomyosis, a fibroid and unaffected normal myometrium all results are correlate with histopathological result which was considered as gold standard diagnostic methods. Results using Student’s t test to compare the ADC values of adenomyosis and fibroids. The standard deviation and the mean of the ADC values were as follows: adenomyosis 0.75 ± 0.30, fibroid 0.63 ± 0.29 and myometrium 1.39 ± 0.36. Statically, there was significant difference between the ADC values of normal myometrium and adenomyosis (p < 0.0001), normal myometrium and fibroids (p < 0.0001), and fibroids and adenomyosis (p < 0.001). Conclusion The present study display that ADC values have the possible to quantitatively and significantly differentiate between Adenomyosis and fibroids.

Keywords

Adenomyosis --- fibroid --- ADC value --- leiomyoma --- myoma --- MRI.


Article
A comparative study of ultrasonography & magnetic resonance imaging with pathological results in diagnosis, localization & measurement of uterine leiomyomas

Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2017 Volume: 4 Issue: 1 Pages: 8-19
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

Uterine leiomyomas (fibroids or myomas) are the commonest benign tumor of the pelvic organs in females, accurate mapping of myomas is essential for treatment. Many studies, used ultrasonography (US) and magnetic resonance imaging (MRI) to determine myomas localization, number and measurement, recently concern has been increasing rate of hysterectomy for myoma in women who have complete childbearing. The aim of the study is to compare US, MRI results with pathology that is regard as a gold standard in detection, localization and measurement of the uterine lieomyoma. A comparative study was done during the period from July 2012 to April 2016 in AL-Diawanyia general teaching hospital in Iraq all included female patients had uterine myomas and all of them had pelvic ultrasonography, MRI and hysterectomy, the results were compared with pathological results. Both US and MRI results were compared with pathology result and the correct detection rate of myoma in ultrasound was low (73.3%) if compare with MRI detection rate (98.1%) with significant P 0.001. Mean number of myomas in US was (1.62±1.07), in MRI was (2.14±149) and in pathology was (2.15±1.50), mean diameter of myomas in pathology was 3.49±2.21, in MRI was 3.58±2.21 with P value 0.360 while in US mean number was 4.37±1.73with P value 0.002. Regarding myomas’ localization, there is no significant difference between MRI & pathology (P =0.1573) but there is high significant difference in myomas’ localization in US and pathology(P=0.00889). In conclusions; MRI is indicated when exact myoma mapping is required.

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