The Applications Of Real-time Gray Scale Contrast-enhanced Ultrasonography In Differential Diagnosis Of Benign And Maligant Uterine Lesions

Objective: To investigate the special contrast-enhanced ultrasound imaging of uterine lesions and the value of contrast-enhanced ultrasonography in differential diagnosis of benign and maligant uterine lesions and in evaluating the encroachment of maligant uterine lesions.Methods: Ten people with normal uterus and sixty-one patients with uterine lesions (including twenty-one patients with benign uterine lesions, forty patients with maligant uterine lesions) 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 sixty-one benign and malignant uterine lesions were observed according to dynamic enhanced models: peripheral net pattern, global enhanced pattern, scattering-punctiform enhanced pattern, lamellar enhanced pattern, lumpish enhanced pattern, quickly diffusion enhanced pattern. Lesions of different types showed their special enhancement patterns and time-intensity curves. In contrast parameters, the rise time, relative rise in intensity and rising-slope rate all have significant difference between benign group and malignant group of uterine lesions (P<0.05). On the basis the analysis of ROC curve, the area under ROC curve of rising-time is 0.887 and that of relative rise in intensity is 0.819 and that of rising-slope rate is 0.863. ROC curve shows the cut off values respectively are 12.185s,27.255dB,2.3945db/s, the sensitivities respectively are 92.5%,88.6%,88.6% and the specificities respectively are 61.9%,76.2%,81%. Of cervix lesions, the half-wash out time and the earlier-descent slope rate all have significant difference between benign group and malignant group (P<0.05). On the basis the analysis of ROC curve, the area under ROC curve of the half-wash out time is 0.822 and that of the earlier-descent slope rate is 0.960. ROC curve shows the cut off values respectively are 46.836s,0.2386db/s, the sensitivities respectively are70%,89.3% and the specificities respectively are 88.9%,88.9%. CEUS had greater advantage in evaluating the malignant uterine lesions than conventional ultrasonography (P<0.05).Conclusions: CEUS can demonstrate the microvascularization of uterine lesions dynamicly and consecutively. Through describing the contrast-enhanced patterns and analyzing TIC, CEUS can elevate the accuratissime of ultrasound discriminating between benign and malignant diseases in uterine. CEUS can reveal the malignant uterine lesions more clearly than conventional ultrasonography, which is advantage in evaluating the encroachment of maligant uterine lesions.