Diagnostic value of contrast-enhanced ultrasound in endometrial lesions

To quantitatively analyse the contrast-enhanced ultrasound (CEUS) parameters of endometrial lesions and explore the differences in CEUS parameters between benign and malignant endometrial lesions.

The study enrolled 316 patients who were diagnosed with endometrial lesions and confirmed with histopathology. All patients underwent 2D ultrasonography and CEUS with SonoVue before surgery. There were fifteen imaging parameters were included in this study.

A total of 236 patients were included in this study, with 204 and 32 patients having benign lesions and malignant lesions, respectively. The malignant lesion group had a higher intensity ratio of maximum echo (Imax), 50% rise slope, and 10%-90% rising slope; lower 50% fall slope; shorter time to peak (TTP), rise time (RT), fall time, fall half time, and mean transit time; and larger area under the curve, area under the wash-in curve (WinAUC), area under the wash-out curve, and area under the wash-in and wash-out curve than the benign lesion group. The logistic regression showed that Imax, TTP, wash-in rate (WinR = WinAUC / RT), and age were related to the diagnosis of benign and malignant endometrial lesions. The following logistic regression model was then obtained: In(benign/malignant) = -4.645 + 0.007Imax-0.549ttp + 0.119age + 0.002WinR. The sensitivity and specificity of the model were 93.8% and 92.2%, respectively.

CEUS can provide both qualitative and quantitative information on endometrial angiogenesis and provide a new method for the preoperative differentiation of benign and malignant endometrial lesions.