A study of 100 women clinically suspected of leiomyoma or adenomyosis was conducted using 3D ultrasound, TAS, TVS and Doppler. Peripheral vascularity strongly indicated leiomyoma, while central vascularity and an ill-defined junctional zone indicated adenomyosis. Doppler indices (PI, RI, Vmax) showed significant differences between conditions. Diagnostic sensitivity and specificity for leiomyoma were 93.4% and 95.6%, while for adenomyosis were 95.6% and 93.4%. Doppler combined with 3D ultrasound significantly improves diagnostic accuracy.