OC16.02: Use of contrast‐enhanced ultrasound with SonoVue in differentiation between uterine leiomyoma and uterine adenomyosis

To establish the patterns of contrast-enhanced ultrasound (CE-US) with SonoVue in uterine leiomyomas and adenomyosis. A prospective analysis of pelvic CE-US with SonoVue (Bracco, Milano, Italy) was performed in 10 patients with ultrasound detected leiomyomas and 10 patients with MR proven adenomyosis and 2 patients with surgically proven adenomyosis. The echogenicity, enhancement patterns at different phases on CEUS were evaluated. 9 out of 10 leiomyomas were less than 3 cm in diameter, and 1 was larger than 3 cm in diameter. For lesions with a diameter 3 cm, uterine leiomyoma showed peripheral rim enhancement pattern and reticular central enhancement pattern. 11 of the 12 Adenomyosis revealed diffuse heterogeneous enhancement similar to the surrounding myometrium with areas of nonenhancement (corresponding to cystic areas) giving the classical Moth eaten appearance. One of the patients with a leiomyoma pattern of enhancement turned out to be a adenomyoma on surgery. Real time CE-US with SonoVue has definitive patterns emerging for the diagnosis of adenomyosis and leiomyomas and can become an important preoperative diagnostic tool for the differentiation of the same.