Li Zemin, Zhang Peili, Shen Huiming, Ding Bo, Wang Haili, Li Jia, Shen Yang
Department of Obstetrics and Gynaecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Department of Ultrasound, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
J Obstet Gynaecol Res. 2021 Jan;47(1):311-319. doi: 10.1111/jog.14527. Epub 2020 Oct 18.
To improve the accuracy of clinical diagnosis by analyzing different contrast-enhanced ultrasound (CEUS) imagines of specific subtypes of uterine leiomyomas.
A total of 147 female patients received preoperative CEUS examination. The scanning plane of the biggest tumors for CEUS was found by common B-mode ultrasonographic scanning on pelvic cavity, then 1.5 mL SonoVue were injected into the median cubital vein. According to the CEUS images, the lesion enhanced time, enhanced level and enhanced morphology were recorded. The time-intensity curve was acquired and analyzed, meanwhile, the relevant parameters were calculated, including rise time (RT), peak intensity (PI), time to peak (TTP) and mean transit time (MTT).
In cellular uterine leiomyoma group, the percentage of high enhancement, early enhancement was higher, equal enhancement and synchronic enhancement were lower than those in the common uterine leiomyomas group. In hysteromyoma with hyaline degeneration group, the percentage of high enhancement, early enhancement was lower, while low enhancement and delayed enhancement were higher than those in the common uterine leiomyomas group. The ratio of PI in cellular uterine leiomyoma group was the highest, but the ratios of RT, TTP and MTT were the lowest of the three benign groups. The ratio of PI in hysteromyoma with hyaline degeneration group was the lowest, while the ratios of RT and TTP was the highest among the three benign groups.
Different pathological types of uterine leiomyomas have their own signal performance on CEUS. CEUS can be used to infer their pathological types and help differential diagnosis.
通过分析不同亚型子宫平滑肌瘤的超声造影（CEUS）图像，提高临床诊断的准确性。
147例女性患者接受术前CEUS检查。通过盆腔常规B超扫描找到最大肿瘤的CEUS扫描平面，然后将1.5 mL声诺维注入肘正中静脉。根据CEUS图像记录病变的增强时间、增强程度和增强形态。获取并分析时间-强度曲线，同时计算相关参数，包括上升时间（RT）、峰值强度（PI）、达峰时间（TTP）和平均通过时间（MTT）。
细胞性子宫平滑肌瘤组高增强、早期增强的比例高于普通子宫平滑肌瘤组，等增强和同步增强的比例低于普通子宫平滑肌瘤组。玻璃样变性子宫平滑肌瘤组高增强、早期增强的比例低于普通子宫平滑肌瘤组，低增强和延迟增强的比例高于普通子宫平滑肌瘤组。细胞性子宫平滑肌瘤组PI比值最高，但RT、TTP和MTT比值在三个良性组中最低。玻璃样变性子宫平滑肌瘤组PI比值最低，而RT和TTP比值在三个良性组中最高。
不同病理类型的子宫平滑肌瘤在CEUS上有各自的信号表现。CEUS可用于推断其病理类型，有助于鉴别诊断。
