Abstract
Objective. The goal of this study was to explore the clinical value of combining two-dimensional (2D) and three-dimensional (3D) transvaginal contrast-enhanced ultrasounds (CEUS) in diagnosis of endometrial carcinoma (EC). Methods. In this prospective diagnostic study, transvaginal 2D and 3D CEUS were performed on 68 patients with suspected EC, and the results of the obtained 2D-CEUS and 3D-CEUS images were compared with the gold standard for statistical analysis. Results. 2D-CEUS benign endometrial lesions showed the normal uterine perfusion phase while EC cases showed early arrival and early washout of the contrast agent and nonuniform enhancement. The 3D-CEUS images differed in central blood vessel manifestation, blood vessel shape, and vascular pattern between benign and malignant endometrial lesions (P < 0.05). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of transvaginal 2D-CEUS and 2D-CEUS combined with 3D-CEUS for diagnosis of benign and malignant endometrial lesions were 76.9%, 73.8%, 64.5%, 83.8%, and 75.0% and 84.6%, 83.3%, 75.9%, 89.7%, and 83.8%, respectively. Conclusion. 3D-CEUS is a useful supplement to 2D-CEUS and can clearly reveal the angioarchitecture spatial relationships between vessels and depth of myometrial invasion in EC. The combined use of 2D and 3D-CEUS can offer direct, accurate, and comprehensive diagnosis of early EC.
Highlights
Endometrial carcinoma (EC) is the second most predominant cancer of the female reproductive tract, typically occurring in perimenopausal women around 50 years of age
After the sagittal plane of the uterus and endometrial morphology were clearly revealed in the 2D mode, contrast-enhanced ultrasounds (CEUS) mode was begun with the suspected myometrial invasion or the deepest invasion serving as the section of interest
Malignant and benign endometrial lesions were found to differ during the perfusion phase of the contrast agent, which is consistent with the findings reported by Chen et al [18]
Summary
Endometrial carcinoma (EC) is the second most predominant cancer of the female reproductive tract, typically occurring in perimenopausal women around 50 years of age. Ultrasonography, hysteroscopy, curettage, and other ways have been widely used in differential diagnoses of endometrial lesions. The depth of myometrial invasion is an important factor affecting the 5-year survival and recurrence of endometrial cancer. Curettage has the benefit of early diagnosis in endometrial carcinoma but demonstrates a degree of difficulty when evaluating the myometrial invasion. Hysteroscopy is considered the gold standard in the diagnosis of intrauterine lesions [2], but it is an invasive examination method and cannot evaluate the degree of myometrial invasion. MRI clearly shows the uterus and pelvic lymph nodes of each layer structure; this is the most reliable method of identifying cervical involvement, but it is unpredictable in estimating the depth of myometrial invasion 79.2%∼ 91.4% [3, 4].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
