Research On CEUS Sonographic Features And TIC Parameters In The Diagnosis Of Uterine Adenomyosis

Objective:In this study, using CEUS technology (Contrast-enhanced Ultrasonography,CEUS) and time-intensity curve (Time-Intensity Curve,TIC) analysis softwareresearch the sonographic features and TIC parameters of uterine adenomyosis,comparedwith the normal group.Whether the comparison between the two parameters wasstatistically significant, to investigate the clinical value of contrast-enhanced ultrasoundfor diagnosis of adenomyosis characteristics, in order to improve the accuracy ofdiagnosis of uterine adenomyosis.Methods:Collected the femal patients with uterine adenomyosis and normal fromNovember2012to December2013in Yijishan Hospital of Wannan Medical College.Allpersons were examined with ultrasonography and CEUS.Adenomyosis is normalendometrial glands and stroma in the myometrium.By the extent of disease, uterineadenomyosis can be divided into diffuse adenomyosis and focal adenomyosis.Diffuseadenomyosis is diffuse lesions in the myometrium.Focal adenomyosis is the nodularlesions in the myometrium,which was also known as uterine adenomyoma.Theadenomyosis patients were divided into diffuse group and focal group.The normalhealthy women as normal group.Machine is Toshiba APLIO XG790color Dopplerultrasonography with PVT-375BT probe of2.0~5.0MHz,using contrast harmonicimaging (Contrast Harmonic Imaging, CHI) and acoustic quantification time-intensitycurve software.Contrast media was SonoVue, which was produced by the company ofItalian Bracco,at a dose of2.0~2.2ml, injected into the elbow by bolus intravenous superficial way.All person were observed and compared contrast perfusion sonographicfeatures and TIC parameters by TIC Software to analyze the different parameters amongdiffuse group, focal group and normal group,in order to investigate the clinical value ofcontrast-enhanced ultrasound in the diagnosis of uterine adenomyosis.Results:CEUS performance:①In diffuse adenomyosis group,26cases (26/30,86.67%)lesions were enhanced with the form of dendritic and4cases (4/30,13.33%) lesionswere enhanced with irregular nodular enhancement from the periphery to central in theearly enhancement.After the peak,30cases (30/30,100%)lesions and the surroundingmyometrium were without borders.22cases (22/30,73.33%) lesions showedinhomogeneous enhancement,8cases (8/30,26.67%) lesions showed homogeneousenhancement.20cases (20/30,66.67%) lesions showed a high enhancement,6cases(6/30,20%) lesions showed low enhancement,4cases (4/30,13.33%) lesions showedequal enhancement.When the contrast media subsided,30cases (30/30,100%) lesionswere synchronized subsided with the surrounding myometrium.②In focal adenomyosisgroup,9cases(9/12,75%) lesions were enhanced with the form of dendritic and3cases(3/12,25%) lesions were enhanced with irregular nodular enhancement from theperiphery to central in the early enhancement.After the peak,12cases (12/12,100%)lesions and the surrounding myometrium were without borders.8cases (8/12,66.67%)lesions showed inhomogeneous enhancement,4cases (4/12,33.33%) lesions showedhomogeneous enhancement.7cases (7/12,58.33%) lesions showed a highenhancement,3cases (3/12,25%) lesions showed low enhancement,2cases(2/12,16.67%) lesions showed equal enhancement.When the contrast agent subsided,12cases (12/12,100%) lesions were synchronized subsided with the surroundingmyometrium.③In normal group,10cases normal endometriumn were enhanced with theform of dendritic from the myometrium surrounding to the surface of endometrialin inthe early enhancement.After the peak, the myometrium showed homogeneous and equalenhancement.When the contrast agent subsided, myometrium faded from the endometrium to the surrounding myometrium.TIC results:①The difference of arrivaltime were not statistically significant among diffuse group,focal group and normalgroup (P>0.05).②The difference of time to peak,rise time and IMAX were notstatistically significant among diffuse group,focal group and normal group (P>0.05).③The difference of time to peak,rise time and IMAX were statistically significantbetween normal group and diffuse group,or between normal group and focalgroup(P<0.05).Time to peak of diffuse or focal group faster than normal group.Risetime is shorter than the normal group.IMAX higher than the normal group.Conclusions:(1) The different of the uniform with the peak intensity and the peakintensity level was statistically significant.performance characteristics between uterineadenomyosis and normal uterine by contrast-enhanced ultrasonography.Compared withnormal uterus contrast performance, adenomyosis ultrasound contrast enhancement withhigh heterogeneity as the main performance, which is useful for the diagnosis ofadenomyosis.(2) The difference of time to peak,rise time and IMAX was statisticallysignificant between adenomyosis and normal uterus by TIC.Time to peak ofdifadenomyosis faster than normal uterus.Rise time is shorter than the normaluterus.IMAX higher than the normal uterus.The difference of TIC parameters providean important reference for the quantitative analysis diagnosis of adenomyosis.