The use of echo-enhancing contrasts in gynecology

Abstract

Echo-enhancing contrasts enable more complete visualization of ovarian and uterine blood vessels in both normal and abnormal conditions. In this review, we report on the advantages of echo-enhanced B-mode imaging, harmonic B-mode imaging, harmonic power Doppler imaging, pulse-inversion imaging, release-burst imaging and subharmonic imaging. Enhanced three-dimensional (3D) power Doppler imaging was used to determine whether the imaging patterns of identified vessels could be correlated with histopathological results, and to evaluate whether the information obtained with echo-enhanced 3D power Doppler ultrasound could improve the diagnostic accuracy in adnexal lesions, compared to that with non-enhanced 3D power Doppler ultrasound. The presence of penetrating vessels was used as a diagnostic criterion for ovarian malignancy. Non-enhanced 3D power Doppler ultrasound in this study demonstrated a diagnostic sensitivity of 58.33% and a specificity of 96.97%. With regard to differential diagnosis between malignant and benign ovarian lesions, contrast-enhanced 3D power Doppler sonography reached a diagnostic sensitivity and specificity of 100% and 93.94%, respectively. The practical value of this modality requires further comparative studies of the diagnostic performance of 3D power Doppler ultrasound with and without injection of contrast agents, as well as evaluation of the cost effectiveness.