Study Of Relationship Between The Enhancement Type On Contrast-enhanced Ultrasonography And The Effect Of High Intensity Focused Ultrasound In The Treatment Of Hysteromyoma

Objective:To observe the relationship between the enhancement type on contrast-enhanced ultrasonography (CEUS) and the effect of high intensity focused ultrasound (HIFU) in the treatment of hysteromyoma.Methods:A total of 47 patients of uterine leiomyoma with 65 lesions were enrolled. All cases underwent CEUS with the contrast pulse sequence (CPS) technique before and after HIFU treatment. In order to observe the lesion volume change after HIFU treatment, the follow-up was done with conventional ultrasonography after 2,4,6,9,12 months respectively. Results:Fifteen (23.08%) of the 65 lesions were hyper-enhanced,41 (63.08%) lesions were iso-enhanced and 9 (13.85%) lesions were hypo-enhanced in arterial phase of CEUS before HIFU treatment. After HIFU treatment, no enhancement was found in 45 of the 65 lesions on CEUS, which indicated tumor necrosis. The tumor necrosis rate of hyper-enhanced lesions was lower than that of iso-enhanced and hypo-enhanced lesions (P< 0.05). Following-up showed that the volume of the 45 lesions of tumor necrosis decreased obviously after HIFU treatment (P< 0.05), while the other 20 lesions remained enhancement on CEUS after HIFU treatment, and no significant difference of lesion volume was found before and after HIFU treatment (P>0.05).Conclusion:CEUS can provide information about the feeding vessels of hysteromyoma, and the effect of HIFU treatment among hysteromyoma of varied types of enhancement on CEUS is different.