Qualitative and quantitative features of deep endometriosis in contrast-enhanced ultrasound: An initial experience and literature review

Article type: Research Article

Authors: Zheng, Zijie^{a; 1} | Zhang, Shen^{a; 1} | Zheng, Cheng^a | Wang, Ruxue^a | Zhang, Yanping^a | Chen, Peixin^a | Zhou, Shanglan^a | Luo, Baoming^{a; *} | Di, Na^{a; b; *}

Affiliations: [a] Department of Ultrasound, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China | [b] Department of Ultrasound, the First People’s Hospital of Kashi Prefecture, Xinjiang, China.

Correspondence: [*] Corresponding authors: Baoming Luo, Department of Ultrasound, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiangxi Road, Guangzhou 510120, China. E-mail: luobm@mail.sysu.edu.cn and Na Di, Department of Ultrasound, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiangxi Road, Guangzhou 510120, China. Department of Ultrasound, the First People’s Hospital of Kashi Prefecture, No. 120 Yingbin Avenue, Kashi, Xinjiang 844000, China. E-mail: dina3@mail.sysu.edu.cn.

Note: [1] These authors contributed equally to this work.

Abstract: PURPOSE:This research aims to present the findings of contrast-enhanced ultrasound (CEUS) in a series of patients with proven deep endometriosis (DE) and provide an updated literature review. MATERIALS AND METHODS:Between January 2018 and October 2022, seven patients with DE lesions had their imaging and medical records retrospectively reviewed. Clinical data, recorded images of a standardized conventional B-mode ultrasound, and Sonovue® CEUS were interpreted by two blinded, independent, experienced radiologists in consensus. The enhanced characteristics of the DE lesion on CEUS were also assessed using VueBox® software quantitatively. RESULTS:DE lesion appeared as irregular hypoechoic or heterogeneous on conventional ultrasound with dotted blood flow signal on color Doppler. Six of seven DE lesions showed heterogeneous hypo-enhancement in arterial phases. All the lesions showed a heterogeneous washout rapidly that began in the late arterial phase. In quantified analysis, the mean relative peak enhancement compared with adjacent tissue was 0.47±0.25. CONCLUSION:Our findings and literature review suggested that CEUS could be a feasible and promising non-invasive modality for diagnosing DE.

Keywords: Contrast-enhanced ultrasound, deep endometriosis, VueBox, quantified analysis

DOI: 10.3233/CH-231843

Journal: Clinical Hemorheology and Microcirculation, vol. 85, no. 1, pp. 73-82, 2023