Consensus on revised definitions of Morphological Uterus Sonographic Assessment (MUSA) features of adenomyosis : results of modified Delphi procedure

Autor: Davor Jurkovic, Judith A F Huirne, M J Harmsen, Lil Valentin, Ligita Jokubkiene, Tom Bourne, Christina K. Rasmussen, Wouter J. K. Hehenkamp, D. Timmerman, J. Naftalin, Margit Dueholm, R A de Leeuw, Lucia Lazzeri, Caterina Exacoustos, F Groenman, C De Bruyn, T. Tellum, T. Van den Bosch
Přispěvatelé: Obstetrics and gynaecology, Internal medicine, Amsterdam Reproduction & Development (AR&D), Other Research, APH - Quality of Care, APH - Societal Participation & Health
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Technology
medicine.medical_specialty
Delphi Technique
Modified delphi
Delphi method
DIAGNOSIS
GUIDELINES
Endometrial tissue
Pregnancy
Delphi technique
medicine
Humans
CRITERIA
Radiology
Nuclear Medicine and imaging
Medical physics
3D ultrasound
Adenomyosis
ULTRASOUND
Ultrasonography
Computer. Automation
Science & Technology
TRANSVAGINAL SONOGRAPHY
Radiological and Ultrasound Technology
medicine.diagnostic_test
business.industry
Physics
Uterus
Radiology
Nuclear Medicine & Medical Imaging
Obstetrics & Gynecology
Obstetrics and Gynecology
Musa
Acoustics
ASSOCIATION
ultrasonography
General Medicine
medicine.disease
Ectopic endometrial tissue
Transvaginal ultrasound
Reproductive Medicine
adenomyosis
consensus
AGREEMENT
Myometrium
Female
Human medicine
business
Life Sciences & Biomedicine
Delphi round
Zdroj: Ultrasound in obstetrics and gynecology
Harmsen, M J, Van den Bosch, T, de Leeuw, R A, Dueholm, M, Exacoustos, C, Valentin, L, Hehenkamp, W J K, Groenman, F, De Bruyn, C, Rasmussen, C, Lazzeri, L, Jokubkiene, L, Jurkovic, D, Naftalin, J, Tellum, T, Bourne, T, Timmerman, D & Huirne, J A F 2022, ' Consensus on revised definitions of Morphological Uterus Sonographic Assessment (MUSA) features of adenomyosis : results of modified Delphi procedure ', Ultrasound in Obstetrics and Gynecology, vol. 60, no. 1, pp. 118-131 . https://doi.org/10.1002/uog.24786
Ultrasound in Obstetrics and Gynecology, 60(1), 118-131. John Wiley and Sons Ltd
ISSN: 0960-7692
DOI: 10.1002/uog.24786
Popis: OBJECTIVES: To evaluate whether the Morphological Uterus Sonographic Assessment (MUSA) features of adenomyosis need to be better defined and, if deemed necessary, to reach consensus on the updated definitions. METHODS: A modified Delphi procedure was performed among European gynecologists with expertise in ultrasound diagnosis of adenomyosis. To identify MUSA features that might need revision, 15 two-dimensional (2D) video recordings (four recordings also included three-dimensional (3D) still images) of transvaginal ultrasound (TVS) examinations of the uterus were presented in the first Delphi round (online questionnaire). Experts were asked to confirm or refute the presence of each of the nine MUSA features of adenomyosis (described in the original MUSA consensus statement) in each of the 15 videoclips and to provide comments. In the second Delphi round (online questionnaire), the results of the first round and suggestions for revision of MUSA features were shared with the experts before they were asked to assess a new set of 2D and 3D still images of TVS examinations and to provide feedback on the proposed revisions. A third Delphi round (virtual group meeting) was conducted to discuss and reach final consensus on revised definitions of MUSA features. Consensus was predefined as at least 66.7% agreement between experts. RESULTS: Of 18 invited experts, 16 agreed to participate in the Delphi procedure. Eleven experts completed and four experts partly finished the first round. The experts identified a need for more detailed definitions of some MUSA features. They recommended use of 3D ultrasound to optimize visualization of the junctional zone. Fifteen experts participated in the second round and reached consensus on the presence or absence of ultrasound features of adenomyosis in most of the still images. Consensus was reached for all revised definitions except those for subendometrial lines and buds and interrupted junctional zone. Thirteen experts joined the online meeting, in which they discussed and agreed on final revisions of the MUSA definitions. There was consensus on the need to distinguish between direct features of adenomyosis, i.e. features indicating presence of ectopic endometrial tissue in the myometrium, and indirect features, i.e. features reflecting changes in the myometrium secondary to presence of endometrial tissue in the myometrium. Myometrial cysts, hyperechogenic islands and echogenic subendometrial lines and buds were classified unanimously as direct features of adenomyosis. Globular uterus, asymmetrical myometrial thickening, fan-shaped shadowing, translesional vascularity, irregular junctional zone and interrupted junctional zone were classified as indirect features of adenomyosis. CONCLUSION: Consensus between gynecologists with expertise in ultrasound diagnosis of adenomyosis was achieved regarding revised definitions of the MUSA features of adenomyosis and on the classification of MUSA features as direct or indirect signs of adenomyosis. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. ispartof: ULTRASOUND IN OBSTETRICS & GYNECOLOGY vol:60 issue:1 pages:118-131 ispartof: location:England status: published
Databáze: OpenAIRE
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