Microvascular flow imaging of fibroids: A prospective pilot study

Area of Science:

• Gynecology
• Medical Imaging
• Ultrasound Technology

Background:

• Assessing uterine fibroid vascularity is crucial for predicting growth and guiding therapy.
• Microvascular (MV) flow imaging is an emerging ultrasound technique capable of detecting slow blood flow in small vessels.
• Limited data exists on the feasibility, reproducibility, and reliability of MV-flow imaging in fibroids.

Purpose of the Study:

• To determine the reproducibility of MV-flow imaging in assessing uterine fibroids.
• To explore the clinical utility of MV-flow imaging for evaluating blood flow within fibroids.

Main Methods:

• Prospective study of 30 patients with uterine fibroids.
• Transvaginal ultrasound using 2D MV-Flow™ and 2D/3D power Doppler.
• Assessment of intra- and inter-observer agreement for vascular index (VI) and color score (CS).
• Evaluation of vascular structure visualization, vascularity assessment, and signal penetration depth.

Main Results:

• High inter- and intra-observer correlations (0.992-0.996) for both 2D MV-flow and 2D power Doppler parameters.
• 2D MV-flow provided more detailed visualization of vascular structures compared to power Doppler.
• Central fibroid blood flow was visualized more effectively with 2D MV-flow (63%) than 2D power Doppler (13%).
• 2D MV-flow demonstrated greater ultrasound signal penetration depth (3.92 cm) than 2D power Doppler (2.95 cm).

Conclusions:

• 2D MV-flow imaging exhibits high reproducibility for evaluating uterine fibroid vascularity.
• This technique offers potential clinical value by visualizing detailed vascular structures and vascularity, particularly in the fibroid core.