Contrast-enhanced ultrasound performance of endometrioma treated with high-intensity focused ultrasound (HIFU)

Objective: This study is to investigate the application of contrast-enhanced ultrasound in assessment of High-Intensity Focused Ultrasound (HIFU) in treating endometrioma. Methods: Totally 60 patients with endometrioma were included in this study, who underwent HIFU in our hospital from June 2014 to July 2016. At 3 d before treatment, and at 1, 3, 6, and 12 months after treatment, contrast-enhanced ultrasound were performed to assess the HIFU treatment effects. Results: Contrast-enhanced ultrasound showed that, 49 (81.67%) and 11 (18.4%) cases exhibited dendritic and gradual enhancement patterns, respectively. After peak, there was no clear boundary between adenomyoma lesion and surrounding tissue. Totally 38 (63.34%) and 22 (36.67%) cases exhibited non-uniform and uniform enhancement, respectively. Along with contrast agent dissipation, the lesion area and surrounding myometrium showed synchronous regression in 60 cases (100%). Timeintensity curve analysis showed that, there was no significant difference in AT, while compared with control, TTP and RT were significantly shorter, and Imax was significantly higher, in the adenomyoma group. ROC analysis showed that, AUC values for TTP, Imax, and RT were 0.88, 0.89, and 0.87, respectively. Compared with 3 d before treatment, the maximum diameter was decreased, while the nonperfusion volume was significantly increased, at 6 and 12 months post-operation. In the follow-up period, significant differences were observed in the tumor ablation rate and tumor residual rate. Conclusion: Real-time perfusion monitoring during HIFU with contrast-enhanced ultrasound contributes to diseases diagnosis and ablation assessment in the disease treatment.