Application Research Of Ultrasound Contrast Agent SonoVue In Ultrasonic Differential Diagnosis Of Benign And Malignant Ovarian Tumors

OBJECTIVE:To assess the efficacy of ultrasound contrast agent SonoVue in evaluating vascularization of ovarian tumor,To investigate the types of curve and parameters of time-intensity curve(TIC) of contrast-enhanced ultrasound(CEUS) used in differentiating ovarian malignant tumors from benign tumors.METHEDS:1.Clinical data:Fifty-four patients with oarian tumors were submitted to color Doppler by transvaginal sonography or abdominal ultrasound from October 2007 to October 2008,all patients received a microbubble contrast agent before surgery, they were hospitalized surgical treatment after a weekthe.We observed their physical symptoms when they were making ultrasonic imaging radiography.2.Reagents and equipment:The equipment in the stuty was American LOGIQ9 GE probe frequency is 4MHZ,vaginal probe frequency is 9.5 MHz.Angiography and instruments' Conditions were consistent,Ultrasound contrast agents we used was SonoVue,56mg/bottle,from Italian Bracco company.3.Assay method:(1)According to conventional ultrasonic transvaginal,we measured all pelvic mass. and observed the thickness of masses'wall and diaphragm for Sassone echogenicity quantitative grading.Then observed internal and sufficiency vessels distribution and vessels form and the distortion degree of the mass,measured Pulsativity index(PI) and resistance index(RI). (2)Extraction with 5ml saline water injection into freeze-dried powder of SonoVue. Shocked immediately and stopped when powder was scattered completely,this time SonoVue forming micro suspension liquid,Choosed the best views to observe lesions and entered the low pressure matching real-time imaging state,This screen was almost invisible gray-scale images of uterine lesions,SonoVue was injected as a bolus by cubital vein followed by 5ml physiological saline.Imaging process about 3—7 minutes.Dynamic imaging process are preserved in instrument built-in hard disk. Image post-processing methods:entered Wash-in/Wash-out state,and used the built-in acoustic quantitative time-strength curve(Time-intensity curve,the TIC),automatic analysis software cardiography curve with different sampling area as the real hand techniques include venereal,simultaneously with the normal method of automatic marked contrast myometrium 6mm(diameter round).4.Results judge:(1) Angiography results criteria:the number of blood vessels,half quantitative grading distortion degree grade,doppler signal enhancement effect,according to the classification standard of Kedar,JiangYuXin as adopted by the criteria.(2)Vaginal ultrasound Sassone rating point selected:≥9 and PI<1.0 RI≤0.4,RI for malignant.5.Statistical method:Measuring parameters were expressed by((?)±s),the rate difference of two groups were compared by chi square test,and all by SPSS12.0(for windows).RESULTS:After contrast color Doppler signals in malignant tumors enhanced obviously and character characteristic vessel morphologies were observed.Vessel numbers and tortuosity increased obviously.After contrast time-intensity curve shapes of benign and malignant tumor are different,the performance time-intensity curve of benign tumor performance for speed rise and dorp,the performance time-intensity curve of malignant tumor performance for speed rise and slow dorp;Various parameters are as follows:(1) By arithmetical average bar chart can seen,Doppler signal enhancement starting time and reach the peak time,malignant tumors shorter than benign tumors, but no significant statistical differences;(2) The peak intensity and semi-limitation time of the malignant tumors are higher than the benign tumors,and which have significant statistical difference(P＜0.05).ROC curves show that when the vessel Doppler signal enhancement of semi-limitation time≥155s and peak intensity≥-43.5 dB diagnose malignant tumor,at which the sensitivity and specificity were the maximum.CONCLUSIONS:SonoVue,as a contrast agent,increases the intensity of color Doppler signals obviously,helps CDFI more accurately evaluation of vascular to the tumor,and allows a more complete disply of the vascular patterns of ovarian tumor.It improves markedly the role of CDFI in the diagnosis and differentiation of ovarian tumor.so,SonoVue has important value of clinical applications.