The Applications Of Real-Time Gray Scale Contrast-Enhanced Ultrasonography In The Diagnosis And Treatment Of Focal Uterine Lesions

Objective:To investigate the special contrast-enhanced ultrasound imaging of focal uterine lesions and the value of contrast-enhanced ultrasonography in diagnosis and treatment of focal uterine lesions.Methods:Ten people with normal uterus and ninety-seven patients with one hundred and eleven focal uterine lesions (including sixty-eight patients with seventy-six benign uterine lesions, ten patients with ten malignant uterine masses and nineteen patients with twenty-five benign uterine lesions which had accepted therapeutic radiofrequency ablation, RFA) were examinated by the contrast-enhanced ultrasonography(CEUS) with SonoVue. The enhancement patterns and the time-intensity curves of lesions were analyzed . The results of CEUS were compared with those of conventional ultrasonography and pathology, P<0.05 is meaningful. Results: Six enhancement patterns in one hundred and eleven focal uterine lesions were observed according to dynamic enhanced models: peripheral net pattern, slow moving to centripetal pattern, global enhanced pattern, un-enhanced pattern, coincident enhanced pattern and lumpish enhanced pattern. Five types of time-intensity curves were obtained: rapid rising rapid descending shape, rapid rising slow descending shape, slow rising slow descending shape, straight line shape and peak shape. Lesions of different types showed their special enhancement patterns and time-intensity curves. CEUS is superior to conventional ultrasonography in differentiating myoma from adenomyosis. The sensitivity ,peculiarity ,accuracy ,positive predictive value and negative predictive value of CEUS used in diagnosising focal uterine lesions were 97.7%,70.6% ,90.0%,89.4% and 92.3% respectively. CEUS had greater advantage in evaluating RFA than conventional ultrasonography with the diagnosis accuracy rising from 80.0% to 100%.Conclusions:CEUS can demonstrate the microvascularization of focal uterine lesions dynamicly and consecutively. Each type of lesions has their special enhancement pattern and time-intensity curve. CEUS led to an improvement in differentiating myoma from adenomyosis and differentiating malignant uterine masses from benign uterine lesions. CEUS revealed a better definition of malignant masses than conventional ultrasonography, which led to an improvement in evaluating the expanding degree of malignant masses. The applications of CEUS improved the effect and safety of RFA. CEUS is well worth carrying out in clinical application.