Uterine Evaluation Using Morphological Uterus Sonographic Assessment Diagnostic Protocol: A Literature Review

Authors

  • Muhammad Rusda Department of Obstetrics and Gynaecology, Division of Reproductive Endocrinology and Infertility, Medical Faculty, Universitas Sumatera Utara, Medan, Indonesia
  • Muhammad Rafi Junior Adnani Department of Obstetrics and Gynaecology, Division of Reproductive Endocrinology and Infertility, Medical Faculty, Universitas Sumatera Utara, Medan, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.9294

Keywords:

Ultrasonography, Morphological Uterus Sonographic Assessment, Myometrium

Abstract

Background: Myometrial lesion is one of the major causes of the need for gynecologic surgeries. Ultrasonography (USG) is the primary modality in myometrial radiological examination. Thus a consistent procedure for reporting evaluation findings is needed. 

Method: We reviewed literature from textbooks and journals from 2000 to 2019 containing information about myometrial sonographic evaluation. 

Results: MUSA (Morphological Uterus Sonographic Assessment) is a consensus statement on terms, definitions, and measurements that may be used to describe findings and report the sonographic features of the myometrium using gray-scale sonography, colour/power Doppler and three-dimensional (3D) ultrasound imaging. The procedure consists of reports on the sonographic features of the uterine corpus, myometrium, and myometrial lesion.  

Conclusion: The need for a standardized terminology to describe sonographic findings of the myometrium, both normal and pathological, has given this protocol an advantage to show its benefit, that is not only just for a clinical background but also research purposes. We suggest researchers and clinicians continue to develop further and study the relevance and use of the consensus, especially the correlation of sonographic findings with clinical and histological features. 

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References

Stewart EA. Benign uterus disorders. In: Strauss JF, Barbieri RL, editors. Yen and Jaffe’s Reproductive Endocrinology. Amsterdam, Netherlands: Elsevier; 2009. p. 597. DOI: https://doi.org/10.1016/B978-1-4160-4907-4.00025-5

Van den Bosch T. Uterine evaluation using a diagnostic protocol based on MUSA. In: How to Perform Ultrasonography in Endometriosis. Cham: Springer; 2018. p. 37-45. https://doi.org/10.1007/978-3-319-71138-6_4 DOI: https://doi.org/10.1007/978-3-319-71138-6_4

Van den Bosch T, Dueholm M, Leone FP, Valentin L, Rasmussen CK, Votino A, et al. Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: A consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group. Ultrasound in Obstet Gynecol. 2015;46(3):284-98. https://doi.org/10.1002/uog.14806 DOI: https://doi.org/10.1002/uog.14806

Leone FP, Timmerman D, Bourne T, Valentin L, Epstein E, Goldstein SR, et al. Terms, definitions and measurements to describe the sonographic features of the endometrium and intrauterine lesions: A consensus opinion from the International Endometrial Tumor Analysis (IETA) group. Ultrasound Obstet Gynecol. 2010;35(1):103-12. https://doi.org/10.1002/uog.7487 PMid:20014360 DOI: https://doi.org/10.1002/uog.7487

Escalante NM, Pino JH. Arrangement of muscle fibers in the myometrium of the human Uterus: A mesoscopic study. MOJ Anat Physiol. 2017;4(2):131-5. https://doi.org/10.15406/mojap.2017.04.00131 DOI: https://doi.org/10.15406/mojap.2017.04.00131

Standring S, editor. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 1st ed. Amsterdam, Netherlands: Elsevier; 2016. p. 1294, 99, 1300.

Moorthy RS. Transvaginal sonography. Med J Armed Forces India. 2000;56(3):181-3. https://doi.org/10.1016/s0377-1237(17)30160-0 PMid:28790701 DOI: https://doi.org/10.1016/S0377-1237(17)30160-0

Exacoustos C, Luciano D, Corbett B, De Felice G, Di Feliciantonio M, Luciano A, et al. The uterine junctional zone: A 3-dimensional ultrasound study of patients with endometriosis. Am J Obstet Gynecol. 2013;209(3):248.e1-7. https://doi.org/10.1016/j.ajog.2013.06.006 PMid:23770466 DOI: https://doi.org/10.1016/j.ajog.2013.06.006

Naftalin J, Hoo W, Nunes N, Mavrelos D, Nicks H, Jurkovic D. Inter‐and intraobserver variability in three‐dimensional ultrasound assessment of the endometrial-myometrial junction and factors affecting its visualization. Ultrasound Obstet Gynecol. 2012;39(5):587-91. https://doi.org/10.1002/uog.10133 PMid:22045594 DOI: https://doi.org/10.1002/uog.10133

Dan Adrian MR. Subserous uterine leiomyoma. Majalah Kedokteran Nusantara. 2007;40(4):303-6.

Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynecol Obstet. 2011;113(1):3-13. https://doi.org/10.1016/j.ijgo.2010.11.011 PMid:21345435 DOI: https://doi.org/10.1016/j.ijgo.2010.11.011

Casadio P, Youssef AM, Spagnolo E, Rizzo MA, Talamo MR, De Angelis D, et al. Should the myometrial free margin still be considered a limiting factor for hysteroscopic resection of submucous fibroids? A possible answer to an old question. Fertil Steril. 2011;95(5):1764-8. https://doi.org/10.1016/j.fertnstert.2011.01.033 PMid:21315334 DOI: https://doi.org/10.1016/j.fertnstert.2011.01.033

Kumar A, Kumar A. Myometrial cyst. J Minim Invasive Gynecol. 2007;14(4):395-6. https://doi.org/10.1016/j.jmig.2006.12.009 DOI: https://doi.org/10.1016/j.jmig.2006.12.009

Van den Bosch T, Votino A, Cornelis A, Vandermeulen L, Van Pachterbeke C, Van Schoubroeck D, et al. Optimizing the histological diagnosis of adenomyosis using in vitro three-dimensional ultrasonography. Gynecol Obstet Invest. 2016;81(6):563-7. https://doi.org/10.1159/000445072 PMid:27002642 DOI: https://doi.org/10.1159/000445072

Van den Bosch T, de Bruijn AM, de Leeuw RA, Dueholm M, Exacoustos C, Valentin L, et al. Sonographic classification and reporting system for diagnosing adenomyosis. Ultrasound Obstet Gynecol. 2019;53(5):576-82. https://doi.org/10.1002/uog.19096 PMid:29790217 DOI: https://doi.org/10.1002/uog.19096

Rusda M, Armi W. Correlation Between Age and Abnormal Uterine Bleeding Prevalence in Adam Malik General Hospital Medan. Repositori Institusi Universitas Sumatera Utara, 2017. Available from: https://www.repositori.usu.ac.id/handle/123456789/20293 [Last accessed on 2019 Nov 22].

Rusda M. Differences in Endometrial Curretage Histopathology of Abnormal Uterine Bleeding With and Without Uterine Fibroid. The 7th ASPIRE Kuala Lumpur; 2017.

Naftalin J, Jurkovic D. The endometrial-myometrial junction: A fresh look at a busy crossing. Ultrasound Obstet Gynecol. 2009;34(1):1-11. https://doi.org/10.1002/uog.6432 PMid:19565525 DOI: https://doi.org/10.1002/uog.6432

Guerriero S, Condous G, Van den Bosch T, Valentin L, Leone FP, Van Schoubroeck D, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: A consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol. 2016;48(3):318-32. https://doi.org/10.1002/uog.15955 PMid:27349699 DOI: https://doi.org/10.1002/uog.15955

Okaro E, Condous G, Khalid A, Timmerman D, Ameye L, Huffel SV, et al. The use of ultrasound‐based ‘soft markers’ for the prediction of pelvic pathology in women with chronic pelvic pain-can we reduce the need for laparoscopy? BJOG. 2006;113(3):251-6. https://doi.org/10.1111/j.1471-0528.2006.00849.x PMid:16487194 DOI: https://doi.org/10.1111/j.1471-0528.2006.00849.x

Votino A, Van den Bosch T, Installé AJ, Van Schoubroeck D, Kaijser J, Kacem Y, et al. Optimizing the ultrasound visualization of the endometrial-myometrial junction (EMJ). Facts Views Vis Obgyn. 2015;7(1):60-3. https://doi.org/10.1002/uog.11748 PMid:25897372 DOI: https://doi.org/10.1002/uog.11748

Rusda M. Do We Need To Treat Any of Uterine Abnormality in Fertility Seeking Patient?. Repositori Institusi Universitas Sumatera Utara, 2014. Available from: https://www.repository.usu.ac.id/handle/123456789/54385 [Last accessed on 2019 Nov 22].

Vandermeulen L, Cornelis A, Rasmussen CK, Timmerman D, Van den Bosch T. Guiding histological assessment of uterine lesions using 3D in vitro ultrasonography and stereotaxis. Facts Views Vis Obgyn. 2017;9(2):77-84. PMid:29209483

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Published

2022-08-05

How to Cite

1.
Rusda M, Adnani MRJ. Uterine Evaluation Using Morphological Uterus Sonographic Assessment Diagnostic Protocol: A Literature Review. Open Access Maced J Med Sci [Internet]. 2022 Aug. 5 [cited 2024 Feb. 23];10(T7):209-16. Available from: https://oamjms.eu/index.php/mjms/article/view/9294

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