Application of the Morphological Uterine Scoring Assessment in Ultrasound for Abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB) is a common gynecological condition that disrupts women's health due to irregularities in menstrual frequency, duration, and volume, often resulting in a significant impact on daily life and productivity. Accurate diagnosis of AUB is critical but complicated by its varied etiologies and presentations. Recent advancements in imaging techniques, particularly the Morphological Uterus Sonographic Assessment (MUSA), have enhanced the diagnostic precision of uterine pathologies such as fibroids and adenomyosis. MUSA combines gray-scale sonography, color Doppler, and three-dimensional ultrasound to evaluate uterine abnormalities with standardized terminology, ensuring diagnostic consistency. This study aimed to assess the efficacy of MUSA in diagnosing and managing AUB. A descriptive observational study was conducted on 50 patients at Dr. D. Y. Patil Medical College and Hospital, focusing on pre- and post-menopausal women with clinically symptomatic AUB. Patients underwent detailed ultrasonography, including both transabdominal and transvaginal scans, to evaluate uterine structures and correlate findings with histopathology. Results showed that 62% of patients had adenomyosis, while 38% had fibroids. MUSA effectively differentiated between the two conditions based on key ultrasound characteristics such as serosal contour, junctional zone, myometrial wall symmetry, and echogenicity. Adenomyosis cases showed significantly higher rates of heterogeneous echogenicity and asymmetrical myometrial walls compared to fibroids. Statistical analyses revealed high diagnostic sensitivity and specificity for both conditions, with an overall accuracy of 88.9% for adenomyosis and 94.1% for fibroids. The findings confirm the utility of MUSA in improving diagnostic accuracy and informing management strategies for AUB, particularly in complex cases. The study highlights MUSA as an indispensable tool for clinicians, facilitating enhanced patient outcomes through precise evaluation and treatment of uterine pathologies.