Quantitative contrast-enhanced ultrasonography for the differential diagnosis of endometrial hyperplasia and endometrial neoplasms

Liu,Ying; Xu,Yi; Cheng,Wen; Liu,Xinghan

doi:10.3892/ol.2016.5206

Quantitative contrast-enhanced ultrasonography for the differential diagnosis of endometrial hyperplasia and endometrial neoplasms

Authors:
- Ying Liu
- Yi Xu
- Wen Cheng
- Xinghan Liu
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Affiliations: Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150081, P.R. China, Department of Biochemistry and Molecular Biology, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
Published online on: September 29, 2016 https://doi.org/10.3892/ol.2016.5206
Pages: 3763-3770
Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study aimed to investigate the feasibility of applying contrast‑enhanced ultrasonography (CEUS) imaging technology for distinguishing between benign and malignant endometrial lesions, and to screen markers that could be correlated with the pathological results. In this study, endometrial diseases were diagnosed by biopsy under hysteroscopy and CEUS examinations. The intensity and time parameters of the time‑intensity curve (TIC) were analyzed. The mean arrival time (AT), time‑to‑peak (TTP), rise time (RT), washout half‑time and clearance half‑time of malignant lesions were shorter than those of benign lesions (P<0.05), whereas the average peak intensity (PI) and enhancement intensity (EI) of malignant lesions were higher than those of benign lesions (P<0.05). The receiver operating characteristic curve showed the following cut‑off values: PI, 29.2 dB; EI, 21.35 dB; AT, 12.75 sec; TTP, 26.75 sec; RT, 13.2 sec; clearance half‑time, 89.3 sec; and washout half‑time, 75.45 sec. The lesions with PI, an EI higher than that of the cut‑off and lesions with an AT, TTP, RT, half clearing time and washout half‑time shorter than the cut‑off were considered malignant. The TTP, RT and half clearing time were negatively correlated with microvessel density (MVD), i.e., MVD was higher when the TTP, RT and half clearing time were shorter. Overall, changes in the enhancement and clearing of lesions could be quantitatively analyzed by CEUS TIC and further discriminate benign from malignant lesions. In the present study, CEUS appeared to indirectly reflect blood vessel changes inside the lesions and provided a pre‑operative non‑invasive fast imaging method for the diagnosis of endometrial disease.

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