Clinical value of contrast-enhanced ultrasound for the differential diagnosis of specific subtypes of uterine leiomyomas
Clinical value of contrast-enhanced ultrasound for the differential diagnosis of specific subtypes of uterine leiomyomas
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超声造影鉴别诊断特定亚型子宫肌瘤的临床价值
DOI：
10.1111/jog.14527
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发表时间：
2020-10-18
影响因子：
1.6
通讯作者：
Shen, Yang
中科院分区：
文献类型：
--
作者：
Li, Zemin;Zhang, Peili;Shen, Yang
目的分析不同亚型子宫肌瘤的超声造影（CEUS）图像，提高临床诊断准确率。方法147例女性患者术前均行CEUS检查。采用常规B超扫描盆腔，找到最大肿瘤的CEUS扫描平面，经肘正中静脉注入声诺维1.5mL。根据CEUS图像记录病灶强化时间、强化程度及强化形态。采集并分析时间-强度曲线，计算相关参数：上升时间（RT）、峰值强度（PI）、达峰时间（TTP）和平均通过时间（MTT）。结果富于细胞型子宫肌瘤组高强化、早期强化的比例高于普通型子宫肌瘤组，等强化、同步强化的比例低于普通型子宫肌瘤组。子宫肌瘤透明变性组高强化、早期强化比例较低，低强化、延迟强化比例较高。三种良性病变组中，PI值以富于细胞型子宫肌瘤组最高，RT、TTP和MTT值最低。子宫肌瘤透明变性组PI比值最低，RT和TTP比值最高。结论不同病理类型的子宫肌瘤在CEUS上有其不同的信号表现。超声造影可推断其病理类型，有助于鉴别诊断。
Objective To improve the accuracy of clinical diagnosis by analyzing different contrast-enhanced ultrasound (CEUS) imagines of specific subtypes of uterine leiomyomas. Methods 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). Results 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. Conclusion 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.