The Discussion Of Contrast-enhanced Ultrasound Technology In Diagnosis Of Obstetrics And Common Gynecologic Disease

Contrast-enhanced ultrasonography is the technology of increasing resolution, sensitivity and specificity of the diagnostic ultrasonography tby increasing the difference of the echo between some organizations and surroundings, and the difference of the perfusion phase between different organizations, after injecting contrast agents into the human body. At present, sonovue representing the second generation of micro-bubble contrast agents are used widely, which can real-time dynamically observe the blood perfusion of the focus tissue, and provide a new method for differential diagnosis of lesions. In recent years, the development of new contrast agents and contrast imaging technology has opened up a new area of contrast-enhanced ultrasonography, which is used gradually from the anatomic imaging to the functional imaging of clinical research and application. Contrast-enhanced ultrasonography has displayed the clear clinical value in diagnosing and treating the disease of liver, pancreas, kidney, cardiovascular.On the clinical, gynecology and obstetrics-related disease include disease of vulva, vagina, uterus, Fallopian tube, ovarie, and postpartum-related disease, with the uterine disease most common. Gynecology and obstetrics-related disease including benign lesions such as uterine smooth muscle tumors, endometrial polyps, hydatidiform mole, caesarean scar pregnancy and abdominal incision endometriosis, and malignant lesions such as endometrial cancer, cervical cancer, and so on. Conventional two-dimensional ultrasound can show lesions in shape, size, borders and the internal echo, blood supply of the lesion can be observed by Color Doppler, but display the low sensitivity to low speed of blood flow. Contrast-enhanced ultrasound can compensate for the low sensitivity of color Doppler to low blood flow through the dynamic observation of tissue microcirculation.Analyse comparatively this study of routine ultrasonography and contrast-enhanced Ultrasonography on64cases of common diseases of gynecology and obstetrics-related patients, and standard by pathology. Further analyse on the function of the differential diagnosis by routine ultrasonography and contrast-enhanced ultrasonography to different common gynecological and obstetrics-related diseases, and discuss the value of contrast-enhanced ultrasonography on common gynecological and obsterics-related diseases.Materials and methods1. Clinical data:Between January2011and February2012,64patients were investigate by routine ultrasonography and contrast-enhanced ultrasonography before surgical treatment and pathological examination, whose age was from22to59years, average (36±8).2. Routine ultrasonography:a transvaginal sonographic apparatus with4-8MHz probe, a high frequency sonographic apparatus with4-13MHz probe,(Mylab90Color Doppler ultrasound systems, Estaote medical) was used. Then, the focus were identified by routine ultrasonography, recording the position, the shape, the size, the borders, the internal structure, and the relationship between adjacent, with or without ascites. Then, Collor Doppler Flow Imaging (CDFI)was utilized, observing the blood supply, recording the parameters of PW.3. Contrast-enhanced ultrasonography:5ml Saline solution was injected into each bottle of25mg Sonovue powder (Italy Bracco) and shocked the bottle until become micro-bubble suspensions. After routine ultrasonography and Color Doppler Flow Imaging, select typical section (including substantive components mainly, most rich of blood flow signal, and normal organization around the focus in comparison), switch the system to contrast mode, select CnTI, determine region of interest, inject1.6ml micro-bubble suspensions into elbow midway vein, and wash needles with5ml saline solution. Record the whole process from injecting for more than5minutes, then deposit the dynamic images into computer hard disk for offline analysis.Observe the degree and way of enhancement and dissipatedness of contrast agents in focus, and compare the situation with the surrounding normal tissue.ResultsAmong the64cases which were confirmed by pathology,49cases were benign, including9cases of endometrial polyp,15cases of uterine smooth muscle tumors,12cases of incomplete abortion intrauterine residues,5cases of complete hydatidiform mole,6cases of caesarean scar pregnancy and2cases of abdominal incision endometriosis.13cases were malignant as all endometrial cancer. Images of some cases were similar by conventional two-dimensional ultrasonography and Color Doppler ultrasonography, but different characteristics were showed in the process of contrast-enhanced ultrasonography.ConclusionThrough this study of attempting to apply contrast-enhanced ultrasonography to some of common gynecological and obsterics-related diseases, the information of blood perfusion on the focus displayed. It is easy to accurately distinguish benign and malignant lesions by contrast-enhanced ultrasonography, thus we can help guide clinical treatment.