title: Value of ultrasound shear wave elastography in the diagnosis of adenomyosis.
abstract: BACKGROUND
  The aim of the study was to assess the accuracy of ultrasound shear wave elastography in the diagnosis of adenomyosis.
  
  
  METHODS
  One hundred and fifty three patients were examined. Ninety-seven patients were with suspected adenomyosis and 56 patients were with unremarkable myometrium. Adenomyosis was confirmed in 39 cases (A subgroup) and excluded in 14 cases (B subgroup) in the main group based on morphological examination. All patients underwent ultrasound examination using an Aixplorer (Supersonic Imagine, France) scanner with application of shear wave elastography during transvaginal scanning. Retrospective analysis of the elastography criteria against the findings from morphological/histological examination was performed.
  
  
  RESULTS
  The following values of Young's modulus were found in subgroup A (adenomyosis): Emean - 72.7 (22.6-274.2) kPa (median, 5-95th percentiles), Emax - 94.8 (29.3-300.0) kPa, SD - 9.9 (2.6-26.3) kPa; in subgroup B (non adenomyosis) - 28.3 (12.7-59.5) kPa, 33.6 (16.0-80.8) kPa, 3.0 (1.4-15.6) kPa; in the control group - 24.4 (17.9-32.4) kPa, 29.8 (21.6-40.8) kPa, 2.3 (1.3-6.1) kPa, respectively (P < 0.05 for all comparison with subgroup В and the control group). The Emean cut-off value for adenomyosis diagnosis was 34.6 kPa. The sensitivity, specificity, positive predictive value, negative predictive value and area under curve (AUC) were 89.7%, 92.9%, 97.2%, 76.5% and 0.908. The Emax cut-off value was 45.4 kPa (89.7%, 92.9%, 97.2%, 76.5% and 0.907, respectively).
  
  
  CONCLUSIONS
  This study showed a significant increase of the myometrial stiffness estimated with shear wave elastography use in patients with adenomyosis.
authors.affiliation: Diagnostic Imaging Department, Milton Keynes University Hospital, UK.
authors.forename: S
authors.initials: S
authors.lastname: Acar
authors.affiliation: Diagnostic Imaging Department, Milton Keynes University Hospital, UK.
authors.forename: E
authors.initials: E
authors.lastname: Millar
authors.affiliation: Ultrasound Diagnostics Department, Russian Medical Academy of Postgraduate Education, Russia.
authors.forename: M
authors.initials: M
authors.lastname: Mitkova
authors.affiliation: Ultrasound Diagnostics Department, Russian Medical Academy of Postgraduate Education, Russia.
authors.forename: V
authors.initials: V
authors.lastname: Mitkov
keywords: Ultrasound shear wave elastography; Young’s modulus; adenomyosis; stiffness