OP22.02: Role of contrast‐enhanced ultrasonography and quantitative analysis in the diagnosis of incomplete medical abortion

Abstract

To assess the role of SonoVue combined with contrast tuned imaging (CnTI) in diagnosing incomplete medical abortion, and the value of quantitative analysis. 32 patients with persistent scant vaginal bleeding for more than 14 days after medical abortion were underwent CEUS. Both urinary HCG and serum beta-HCG were tested before CEUS, curettage and histopathology examination after CEUS. Statistical analysis was performed between the residual group and normal group. The role of CEUS in the diagnosis of the incomplete medical abortion was evaluated combined with the lab tests and the basic ultrasound examination. In CEUS, gray scale of residual lesions were enhanced obviously in the residual group. In the normal group, some lesions showed little perfusion of agent, and the whole uterine corpus was heterogeneously enhanced slowly in the other cases, which showed no intralesional contrast perfusion. Based on quantitative analysis, Peak (51.368) and AUC (2.318) in residual group were much higher than that of the normal group, (P < 0.05) while the other parameters such as TP, Sharpness showed no statistic difference between the two groups. In the residual group, Peak (43.1), AUC (1.368) of the local uterine tissue where the residua adhered to were much higher than that of the other side (P < 0.01), whereas all the parameters showed no statistical significance between the two sides in the normal group. Receiver operator characteristic curve was established by Peak. It showed that the sensitivity (90.91%) and specificity (90%) were higher when the cut-off was 46. When urinary HCG test and ultrasound PWD examination was combined as a serial test first, and CEUS quantitative analysis as parallel test, validity of this diagnosing test could be improved significantly with a higher sensitivity (95.45%). CEUS could reveal the vascular pattern and the basement of intrauterine lesion. Combined with HCG test and basic ultrasound examination, quantitative analysis test of CEUS shows a definitely more valuable future in diagnosing.