Study of hemodynamics of the uterine body by the method of three-dimensional energy dopplerography of patients with leiomyoma in different age periods

Authors

DOI:

https://doi.org/10.15587/2519-4798.2019.180470

Keywords:

three-dimensional energy dopplerography, uterine body hemodynamics, uterine leiomyoma

Abstract

To date, there is not enough papers to establish the reproducibility of the calculation of three-dimensional indices of blood flow and their threshold values for the diagnosis of a particular pathology. In this regard, the technique of three-dimensional Doppler sonography requires further study.

The aim of research is studying the hemodynamics of the uterine body of patients with leiomyoma by three-dimensional energy Doppler ultrasonography to determine the possible patterns of changes in the indicators of three-dimensional vascularization indices depending on the phases of the menstrual cycle of women of reproductive age, in perimenopause and at different periods of menopause.

Materials and methods. 326 women between the ages of 18 and 75 were surveyed (Me = 46.5). The comparison group consisted of 157 (48.15 %) healthy women, the main group was 169 women (51.84 %) with uterine leiomyoma. All patients in both groups were divided into women of reproductive age, women in peri - and menopause.

In 3D reconstruction of the uterus using the energy mapping function and the VOCAL (Virtual Organ Computer - aided Analysis) option, an objective assessment of the hemodynamics of the uterine body was performed by calculating the vascularization index (VI), which characterizes the percentage of colour voxels in uterus body volume, flow intensity index (FI), showing the median luminance of colour voxels, which depends on the blood flow velocity in a given three-dimensional volume and vascularization-flow index (VFI), which is a product of multiplying the vascularization index and the flow index, divided by 100.

Result. As a result, the main group identified the patterns of dynamics of three-dimensional indices of blood flow, depending on the survey at different ages, similar to the comparison group. In the reproductive period in patients with uterine leiomyoma, regardless of the size and degree of vascularization, the minimum values of the indexes VI, FI and VFI of the body of the uterus were registered in the early proliferative phase, significantly increasing to the middle secretion phase, coinciding with the fertility period of corpus luteum, secretion (p <0.05, CCU). In peri - and menopause, patients with leiomyomas have a statistically significant dynamics, similar to the nomograms of the comparison group, in reducing the values of the three-dimensional index of perfusion of the VI of the uterus as the period of absence of menstruation increases (CCU, p = 0.0472), with the highest values being characteristic of the perimenopause period. In the analysis of the dynamics of the FI and VFI indices of the body of the uterus of women with perio- and menopausal leiomyomas, the distribution of the studied indices was not confirmed by statistical significance. However, their pattern quite accurately reproduces the dynamics of a gradual decrease in these three-dimensional indices of blood flow in women with uterine body leiomyoma as the duration of absence of menstruation increases: the highest values were characteristic of the perimenopause period and the lowest - for the menopause period of more than 10 years.

Conclusions. Taking into account the revealed patterns of dynamics of indicators of three-dimensional indices of blood flow depending on the age periods of women with leiomyoma will in the future increase the sensitivity and specificity of the method of three-dimensional energy Doppler sonography in the differential diagnosis of proliferative activity of uterine leiomyoma

Author Biographies

Kirill Yakovenko, State Institution «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine» Pushkinska str., 82, Kharkiv, Ukraine, 61024

Postgraduate Student

Department of Oncogynecology

Tamara Tamm, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

MD, Professor, Head of Department

Department of Surgery and Proctology

Elena Yakovenko, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

PhD, Associate Professor

Department of Genetics, Obstetrics, Gynecology and Fetal Medicine

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Published

2019-10-10

How to Cite

Yakovenko, K., Tamm, T., & Yakovenko, E. (2019). Study of hemodynamics of the uterine body by the method of three-dimensional energy dopplerography of patients with leiomyoma in different age periods. ScienceRise: Medical Science, (5 (32), 18–24. https://doi.org/10.15587/2519-4798.2019.180470

Issue

No. 5 (32) (2019)

Section

Medical Science

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Copyright (c) 2019 Kirill Yakovenko, Tamara Tamm, Elena Yakovenko

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