Quartuccio Marco, Liotta Luigi, Cristarella Santo, Lanteri Giovanni, Ieni Antonio, D'Arrigo Tiziana, De Majo Massimo
Department of Veterinary Science, University of Messina, 98168 Messina, Italy.
Animals (Basel). 2020 Aug 7;10(8):1368. doi: 10.3390/ani10081368.
In cystic endometrial hyperplasia (CEH)-pyometra syndrome, toxic factors and endometrial remodeling culminate in changes characterized by exudative and degenerative inflammatory reaction. Recent studies on hemodynamic found an increased blood flow and lower vascular resistance in uterine arteries, suggesting color Doppler ultrasound as an adjunctive tool for quantitative assessment of endometrial vascularization during pyometra. The aim of this study was to assess, through contrast-enhanced ultrasound (CEUS) exam, the vascularization in endometrial microvessels in CEH-pyometra in order to evaluate the possibility of application in this syndrome. In twelve female dogs with clinical symptoms related to pyometra, B-mode, color Doppler and CEUS exams were performed. In CEH-pyometra uteri, histopathological examination revealed severe CEH and pyometra, immunohistochemical stain with CD 34 confirmed the presence of angiogenesis. CEUS exams revealed a widespread, intense and rapidly developing homogeneous enhancement of the hyperplastic endometrium, with absence of signal only in cystic areas. All parameters of the quantitative analysis were not significantly influenced by region of interest dimension and position. CEUS has the potential to improve clinical not invasive evaluations in the CEH-pyometra syndrome and virtually in CEH-mucometra.
在囊性子宫内膜增生（CEH）-子宫积脓综合征中，毒性因子和子宫内膜重塑最终导致以渗出性和退行性炎症反应为特征的变化。最近关于血流动力学的研究发现子宫动脉血流增加且血管阻力降低，这表明彩色多普勒超声可作为子宫积脓期间子宫内膜血管化定量评估的辅助工具。本研究的目的是通过超声造影（CEUS）检查评估CEH-子宫积脓中子宫内膜微血管的血管化情况，以评估其在该综合征中的应用可能性。对12只出现子宫积脓相关临床症状的雌性犬进行了B超、彩色多普勒和CEUS检查。在CEH-子宫积脓的子宫中，组织病理学检查显示严重的CEH和子宫积脓，CD 34免疫组化染色证实存在血管生成。CEUS检查显示增生的子宫内膜广泛、强烈且迅速发展的均匀增强，仅在囊性区域无信号。定量分析的所有参数均不受感兴趣区域大小和位置的显著影响。CEUS有潜力改善CEH-子宫积脓综合征以及实际上CEH-子宫黏液积脓的临床无创评估。
