ИСТИНА

Background: Early diagnosis of adenomyosis in adolescents is a challenge. The aim of the study was to compare ultrasound and MRI data to identify the main signs of the disease. Methods: A total of 45 girls (from menarche to 17 years old) were included in the case-control study with adenomyosis according to hysteroscopy. Results: Adenomyosis was suspected (ADM) in 27% of girls (12/45) according to ultrasound and MRI imaging revealed internal endometriosis in 65% of cases (29/45). The comparison of imaging results with ultrasound and MRI revealed the following key signs of the adenomyo- sis like myometrial heterogeneity (27%, 12/45 and 58%, 26/45, p= 0,0029), uterine wall thickness unevenness (9%, 4/45 and 47%, 21/45, p= 0,0001), endometrial heterogeneity (9%, 4/45 and 54%, 29/45, p = 0), varicose veins of the arcuate plexus (18%, 8/45 and 44%, 20/45, p= 0,0077). Additional ultrasound markers of the adenomyosis were: hypoechogenic rim of the endometrium (9%, 4/45), change in the position of the uterus (11%, 5/45), pear-shaped of the uterus (13%, 6/45). MRI allows to describe the transition zone, for the adenomyosis pathognomonic changes were the uneven contours (47%, 21/45) of the transition zone, heterogeneous structure (47%, 21/45), uneven thickening (36%, 16/45), as well as a decrease in zonal differentiation of the uterus (24%, 11/45). Solutions: ultrasound allows mostly to detect the changes in the myometrium (31%) in third of the patients with the adenomyosis. MRI detailed the transition zone and the characteristics of the endometrium in 65% of the cases.