From the Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Bldg, Chapel Hill, NC 27599 (K.O.); Department of Radiology, University of Toronto, Toronto, Ontario, Canada (X.L.); Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (Parisa Khoshpouri); Department of Radiology, University of Washington, Seattle, WA (Pegah Khoshpouri); Department of Radiology, Yale University, New Haven, CT (L.M.S.); Department of Radiology, University of Kentucky, Lexington, KY (A.K.); Department of Radiology, Jaslok Hospital, Mumbai, India (R.N.C.); and Department of Radiology, Vanderbilt University Medical Center, Nashville, TN (M.M.).
Radiographics. 2024 Feb;44(2):e230092. doi: 10.1148/rg.230092.
Since the first application of contrast-enhanced US (CEUS) in the late 1960s, the use of US contrast agents has grown tremendously, and this examination has proved to be a valuable adjunct to diagnostic US for detection and characterization of disease. Also, CEUS has emerged as an excellent option for evaluation of indeterminate lesions that require additional imaging, given its excellent safety profile, including that in patients with end-stage renal disease or allergies to contrast material who are unable to undergo contrast-enhanced CT or MRI. US traditionally has been considered the imaging modality of choice for evaluation of the female pelvis, followed by MRI and rarely fluoroscopy, CT, PET, or angiography. CEUS has the potential to add significant value in imaging gynecologic disease, and indications for its use in the female pelvis are expected to continue evolving. It can aid in evaluation of nonvascular structures, such as assessment of tubal patency, uterine cavity morphology, and pelvic fistulas. CEUS can help characterize poorly vascularized gynecologic tumors or tissues with slow flow by using qualitative and quantitative parameters and aid in image-guided interventions or biopsies by facilitating visualization of lesions that are difficult to see with other imaging modalities. The authors provide an overview of current applications of US contrast agents in the female pelvis and discuss associated factors such as technique, interpretation, and image optimization. They also discuss the limitations of CEUS and describe its utility in the evaluation of female pelvic disease by using an organ system case-based approach. RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.
自 20 世纪 60 年代末首次应用对比增强超声（CEUS）以来，超声造影剂的应用得到了极大的发展，该检查已被证明是诊断性超声检测和疾病特征描述的有价值的辅助手段。此外，CEUS 已成为评估需要额外成像的不确定病变的绝佳选择，因为其具有出色的安全性，包括那些无法进行对比增强 CT 或 MRI 的终末期肾病或造影剂过敏患者。传统上，超声一直被认为是评估女性盆腔的首选影像学方法，其次是 MRI，很少使用透视、CT、PET 或血管造影。CEUS 在妇科疾病成像方面具有潜在的重要价值，其在女性盆腔中的应用指征预计将继续发展。它可以帮助评估非血管结构，例如评估输卵管通畅性、子宫腔形态和盆腔瘘。CEUS 可以通过使用定性和定量参数来帮助评估血流灌注不良的妇科肿瘤或血流缓慢的组织，并通过促进对其他影像学方法难以看到的病变的可视化，帮助进行图像引导的介入或活检。作者概述了超声造影剂在女性盆腔中的当前应用，并讨论了相关因素，如技术、解释和图像优化。他们还讨论了 CEUS 的局限性，并描述了其在评估女性盆腔疾病方面的实用性，采用器官系统基于病例的方法。
RSNA，2024 年，本文章的测试知识问题可在补充材料中找到。
