MODERN APPROACHES IN THE DIAGNOSIS AND CONSERVING THERAPY OF ADENOMYOSIS
Abstract
At this point in modern gynecology there are no uniform standards in the diagnosis and treatment of adenomyosis. This problem requires special attention, since there is a tendency to increase the incidence of this disease, especially in younger women. The paper presents the data in the literature about the different methods of diagnosis (hysteroscopy, ultrasound, MRI), and provides criteria for evaluation of these methods. Of greatest interest are the data of foreign authors on a new method of treatment of adenomyosis – magnetic resonance- guided focused ultrasound surgery.
About the Authors
A. I. Ishchenko
State Federal-Funded Educational Institution of Higher Vocational Training I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
E. N. Zhumanova
Federal State Department «Center of Medicine and Rehabilitation» Ministry of Health and Social Development of the Russian Federation, Moscow
Russian Federation
Russian Federation
A. A. Ishchenko
Federal State Department «Center of Medicine and Rehabilitation» Ministry of Health and Social Development of the Russian Federation, Moscow
Russian Federation
Russian Federation
O. Yu. Gorbenko
State Federal-Funded Educational Institution of Higher Vocational Training I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
E. A. Chunaeva
Federal State Department «Center of Medicine and Rehabilitation» Ministry of Health and Social Development of the Russian Federation, Moscow
Russian Federation
Russian Federation
E. S. Aghajanyan
State Federal-Funded Educational Institution of Higher Vocational Training I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Ya. S. Savelieva
State Federal-Funded Educational Institution of Higher Vocational Training I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
References
1. Адамян Л.В., Яроцкая Е.Л. Генитальный эндометриоз: дискуссионные вопросы и альтернативные подходы к диагностике и лечению. Журнал акушерства и женских болезней. 2002; 3: 103-111.
2. Баскаков В.П. Клиника и лечение эндометриоза. Л. 1990; 240 с.
3. Бреусенко В.Г., Каппушева Л.М., Мишиева О.И. и др. Эндоскопические критерии аденомиоза. Тезисы доклада конгресса «Эндоскопия в диагностике и лечении патологии матки». М. 1997; 52-53.
4. Дамиров М.М. Генитальный эндометриоз болезнь активных и деловых женщин. М. 2010; 191 с.
5. Демидов В.Н., Адамян Л.В., Хачатрян А.К. Ультразвуковая диагностика аденомиоза. Тезисы доклада конгресса «Эндоскопия в диагностике и лечении патологии матки». М. 1997; 41-44.
6. Дооперационная диагностика аденомиоза: возможности и перспективы комплексного использования лучевых и эндоскопических методов исследования / Н.М. Подзолкова [и др.]. Проблемы репродукции. 2007; 2: 62-70.
7. Ищенко А.И., Кудрина Е.А. Эндометриоз: современные аспекты. М. 2008; 176 с.
8. Магнитно-резонансная томография, спиральная рентгено-компьютерная томография и гистероскопия в диагностике аденомиоза. Адамян Л.В. [и др.]. Тезисы доклада конгресса «Эндоскопия в диагностике и лечении патологии матки». М. 1997; 45-46.
9. Национальное руководство. Гинекология. Под ред. В.И. Кулакова, Г.М. Савельевой, И.Б. Манухина. М. 2009; с. 75.
10. Сидорова И.С., Унанян А.Л. Дифференцированный подход к лечению аденомиоза. Акушерство, гинекология и репродукция. 2011; 2: 16-20.
11. Стрижаков А.Н., Давыдов А.И., Пашков В.М., Лебедев В.А. Доброкачественные заболевания матки. М. 2011; 288 с.
12. Унанян А.Л., Сидорова И.С., Коган Е.А. Активный и неактивный аденомиоз: клинико-морфологические варианты развития, дифференцированный подход к терапии. Акушерство, гинекология и репродукция. 2012; 2: 25-30.
13. Шешукова Н.А., Макаров И.О., Овсянникова Т.В. Гиперпластические процессы эндометрия: особенности пролиферативной активности при сочетании с хроническим эндометритом. Акушерство, гинекология и репродукция. 2011; 3: 10-15.
14. Ascher S.M., Jha R.C., Reinhold C. Benign myometrial conditions: leiomyomas and adenomyosis. Top Magn. Reson. Imaging. 2003; 14: 281-304.
15. Bazot M., Darai E., Hourani R. et al. Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology. 2004; 232: 379-389.
16. Benagiano G., Brosens I., Carrara S. Adenomyosis: new knowledge is generating new treatment strategies. Women’s Health. 2009; 5 (3): 297-311.
17. Bird C.C., McElin T.W., Manalo-Estrella P. The elusive adenomyosis of the uterus. Am. J. Obstet. Gynecol. 1972; 112: 583-593.
18. Bragheto A.M., Caserta N., Bahamondes L., Petta C.A. Effectiveness of the levonorgestrelreleasing intrauterine system in the treatment of adenomyosis diagnosed and monitored by magnetic resonance imaging. Contraception. 2007; 76: 195-9.
19. Brosens J.J., De Souza N.M., Barker F.G. Uterine junctional zone: function and disease. Lancet. 1995; 346: 558.
20. Dong X., Yang Z. High-intensity focused ultrasound ablation of uterine localized adenomyosis. Curr. Opin. Obstet. Gynecol. 2010. 22 (4): 326-30.
21. Fennessy F.M., Tempany C.M., McDannold N.J. et al. Uterine leiomyomas: MR imaging-guided focused ultrasound surgery – results of different treatment protocols. Radiology. 2007; 243 (3); 885-893.
22. Fukunishi H., Funaki K., Sawada K. et al. Early results of magnetic resonance-guided focused ultrasound surgery of adenomyosis: analysis of 20 cases. J. Minim. Invasive Gynecol. 2008; 15 (5): 571-9.
23. Funaki K., Fukunishi H., Funaki T., Sawada K., Kaji Y., Maruo T. Magnetic resonance-guided focused ultrasound surgery for uterine fibroids: Relationship between the therapeutic effects and signal intensity of preexisting T2-weighted magnetic resonance images. Am. J. Obstet. Gynecol. 2007; 196: 184. e1-6.
24. Hindley J., Gedroyc W.M., Regan L. et al. MRI guidance of focused ultrasound therapy of uterine fibroids: early results. AJR Am. J. Roentgenol. 2004; 183 (6): 1713-1719.
25. Imaoka I., Ascher S.M., Sugimura K., Takahashi K., et. al. MR imaging of diffuse adenomyosis changes after GnRH analog therapy. J. Magn. Reson. Imaging. 2002; 15: 285-90.
26. Kanaoka Y., Hirai K., Ishiko O. Successful microwave endometrial ablation in a uterus enlarged by adenomyosis. Osaka City Med. J. 2004; 50: 47-51.
27. Kim M.D., Won J.W., Lee D.Y., Ahn C.S. Uterine artery embolization for adenomyosis without fibroids. Clin. Radiol., 2004; 59: 520-526.
28. Kunz G., Beil D., Huppert P. et al. Adenomyosis in endometriosis – prevalence and impact on fertility. Evidence from magnetic resonance imaging. Hum. Reprod. 2005; 20: 2309-2316.
29. Kunz G., Herbertz M., Beil D., Huppert G., Leyendecker G. Adenomyosis as a disorder of the early and late human reproductive period. Reprod. BioMed. Online. 2007; 15: 681-685.
30. Levgur M. Therapeutic options for adenomyosis: A review. Arch. Gynecol. Obstet. 2007; 276: 1-15.
31. Mariam M., Al Hilli, M.B.B.Ch., Elizabeth A. Stewart, M.D. Magnetic Resonance-guided Focused Ultrasound Surgery. Semin Reprod Med. 2010; 28 (3): 242-249.
32. McCausland A.M., McCausland V.M. Depth of endometrial penetration in adenomyosis helps determine outcome of rollerball ablation. Am. J. Obstet. Gynecol. 1996; 174: 1786-93.
33. Meredith S., Sanchez-Ramos L., Kaunitz A. Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: systematic review and metanalysis. Am. J. Obstet. Gynecol. 2009; 201 (1): 107.
34. Reinhold C., Tafazoli F., Mehio A., Wang L et al. Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation. Radiographics. 1999; 19 Spec No: 147-160.
35. Stewart E.A., Gedroyc W.M., Tempany C.M. et al. Focused ultrasound treatment of uterine fibroid tumors: safety and feasibility of a noninvasive thermoablative technique. Am. J. Obstet. Gynecol. 2003; 189: 48-54.
36. Tamai K., Togashi K., Ito T. et al: MR imaging findings of adenomyosis: correlation with histopathologic features and diagnostic pitfalls. Radiographics. 2005; 25: 21-40.
37. Weiss G., Maseelall P., Schott L.L. et al. Adenomyosis a variant not a disease? Evidence from hysterectomized menopausal women in the Study of Women’s Health Across the Nation (SWAN). Fertil. Steril. 2009; 91: 201-206.
38. Zhou M., Chen J.Y., Tang L.D., Chen W.Z., Wang Z.B. Ultrasound-guided high-intensity focused ultrasound ablation for adenomyosis: the clinical experience of a single center. Fertill. Steril. 2011; 95 (3): 900-5.
Review
For citations:
Ishchenko A.I., Zhumanova E.N., Ishchenko A.A., Gorbenko O.Yu., Chunaeva E.A., Aghajanyan E.S., Savelieva Y.S. MODERN APPROACHES IN THE DIAGNOSIS AND CONSERVING THERAPY OF ADENOMYOSIS. Obstetrics, Gynecology and Reproduction. 2013;7(3):30-34. (In Russ.)
Views: 438
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Email this article 
