To explore application value of transvaginal ultrasound elastography in differential diagnosis of uterine fibroids and adenomyoma.

A retrospective analysis was performed on clinical case data and imaging data of transvaginal ultrasound elastography from 54 uterine fibroids patients and 46 adenomyoma patients confirmed by pathology who were admitted to the Hospital of PLA the 81^st Group Army from January 2017 to February 2019. To compare the diagnostic value, elastography parameters and imaging characteristics of real-time ultrasound elastography in patients with uterine leiomyoma and adenomyoma.

Among 54 patients with uterine fibroids, there were 49 cases confirmed by real-time ultrasound elastography, with diagnostic coincidence rate 90.74% (49/54). Among 46 patients with adenomyoma, there were 40 cases confirmed by real-time ultrasound elastography, with diagnostic coincidence rate 86.96% (40/46). The resistance index of uterine artery in uterine fibroid group was lower than that in adenomyoma group, while strain ratio (SR) between normal muscle layer and lesion was higher than that in adenomyoma group, with statistically significant difference (P<0.05). The real-time ultrasound elastography of uterine fibroids was characterized by regular shape, common rounded shape, and clear boundary. The interior of fibroids was basically blue-green inter-image mainly on blue color. There was green-yellow or red capsule around. The real-time ultrasound elastography of uterine adenomyoma was characterized by irregular shape, unclear boundary, greener color than normal muscle wall, and even yellow-red-green inter-images.

There is certain clinical value of transvaginal ultrasound elastography in differential diagnosis of uterine fibroids and adenomyoma.

Elasticity imaging techniques; Uterine fibroid; Uterine adenomyoma; Diagnosis, differential