Value of contrast-enhanced ultrasound in evaluating blood flow perfusion changes in adenomyosis patients treated with HIFU combined with leuprorelin

To investigate the clinical application value of contrast-enhanced ultrasound (CEUS) technology in evaluating blood flow perfusion changes in adenomyosis patients treated with high-intensity focused ultrasound (HIFU) combined with leuprorelin. A retrospective analysis was conducted on 105 adenomyosis patients admitted to Tianmen First People's Hospital of Hubei Province from January 2023 to June 2024. Patients were divided into three groups according to treatment methods: Group A (HIFU + leuprorelin group, n=35), Group B (leuprorelin group, n=35), and Group C (HIFU group, n=35). All patients underwent CEUS examination before treatment and at 1 week, 1 month, 3 months, and 6 months after treatment. Parameters including arrival time (AT), time to peak (TTP), peak intensity (PI), and area under curve (AUC) were recorded. Clinical symptoms (VAS dysmenorrhea score, PBAC score), imaging indicators (uterine volume, lesion volume), laboratory tests (hemoglobin, CA125, sex hormones), and fertility function were evaluated. There were no statistically significant differences in baseline characteristics among the three groups (P>0.05). At 6 months after treatment, the degree of uterine volume reduction in Group A was significantly greater than that in Groups B and C (P<0.001). VAS dysmenorrhea scores and PBAC scores in Group A were significantly lower than those in Group B (P<0.001). CEUS showed that compared with before treatment, AT and TTP were significantly prolonged, and PI and AUC were significantly decreased in Groups A and C (P<0.05). At 6 months after treatment, PI values in Group A were significantly lower than those in Group B (P<0.001). Correlation analysis showed that PI and AUC were significantly positively correlated with VAS dysmenorrhea scores and PBAC scores (P<0.001), and significantly negatively correlated with hemoglobin levels (P<0.001). Among patients with fertility requirements, the pregnancy rate in Group A was significantly higher than that in Group B (P<0.05). Multiple regression analysis showed that treatment method was the most important independent factor affecting dysmenorrhea improvement, uterine volume reduction, and blood flow perfusion improvement (P<0.001). HIFU combined with leuprorelin treatment for adenomyosis is more effective than single treatment methods, showing significant advantages in improving clinical symptoms, reducing lesion volume, and increasing pregnancy rates. CEUS technology can sensitively reflect changes in lesion blood flow perfusion, providing objective and reliable imaging indicators for clinical efficacy evaluation, which has important clinical application value.