The Use of Shear Wave Elastography, Transvaginal Ultrasound and Pelvic MRI in the Diagnosis of Adenomyosis

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Brief Title

The Use of Shear Wave Elastography, Transvaginal Ultrasound and Pelvic MRI in the Diagnosis of Adenomyosis

Official Title

The Use of Shear Wave Elastography, Transvaginal Ultrasound and Pelvic MRI in the Diagnosis of Adenomyosis

Brief Summary

      In this prospective cohort study, the patients who were diagnosed with either uterine fibroid
      (control group) or adenomyosis (study group), were examined with transvaginal ultrasound and
      shear wave elastography. Definitive diagnosis was established by pelvic MRI. Shear wave
      elastography data of both groups were compared. Features of adenomyosis on transvaginal
      ultrasound were also recorded for study group.

Detailed Description

      In this prospective cohort study, the patients who applied to the Gynecology and Infertility
      Outpatient Clinic in Istanbul University Faculty of Medicine between October 2018 and October
      2021 due to abnormal uterine bleeding, pelvic pain, infertility were evaluated. The patients
      who were diagnosed with adenomyosis and uterine myoma according to clinical evaluation were
      included and grouped. Clinical diagnosis were confirmed with contrast enhanced pelvic
      magnetic resonance imaging. No histopathological confirmation were included in this study. 34
      patients were included in adenomyosis group and 31 patients were included in myoma group. All
      patients were evaluated with shear wave elastography; 3 regions of interest were selected for
      each elastographic evaluation. Average shear values were determined automatically; then,
      minimum and maximum mean shear values were recorded accordingly. Elastography values of both
      groups were compared in order to detect any statistically significant difference between 2
      groups. In addition to elastography evaluation, the compatibility of transvaginal ultrasound
      and magnetic resonance were evaluated.

Study Type


Primary Outcome

Elastography data of adenomyotic lesions and fibroids

Secondary Outcome

 Ultrasonographic features of adenomyotic lesions




Shear wave elastography

Study Arms / Comparison Groups

Description:  Patients who were diagnosed with adenomyosis according to pelvic MRI were examined with transvaginal ultrasound. Certain ultrasonographic features of adenomyosis ( asymmetrical uterine wall thickening, myometrial cysts, fan shaped lines and shadows, presence of irregular junctional zone, presence of clue sign, global enlargement) were recorded. Then the patients were examined with shear wave elastography. Maximum and minimum median shear wave values were recorded through the selected regions of interest.


* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information

Recruitment Status


Estimated Enrollment


Start Date

October 1, 2018

Completion Date

January 1, 2022

Primary Completion Date

October 1, 2021

Eligibility Criteria

        Inclusion Criteria:

          -  Patients who applied to outpatient clinic due to abnormal uterine bleeding, pelvic
             pain, infertility.

        Exclusion Criteria:

          -  Patients who are currently pregnant or has current malignancy, use combined oral
             contraceptives, gonadotropin releasing hormone agonist, intrauterine device or
             currently taking hormonal replacement therapy.




18 Years - 60 Years

Accepts Healthy Volunteers



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Location Countries


Location Countries


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Organization ID


Responsible Party

Principal Investigator

Study Sponsor

Istanbul University

Study Sponsor

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Verification Date

June 2022