Perioperative effect of contrast-enhanced ultrasound in percutaneous microwave ablation of uterine muscle benign lesions

Objective To assess the value of contrast-enhanced ultrasound(CEUS)in evaluating the therapeutic efficacy of percutaneous microwave ablation on benign uterine muscle lesions.Methods Ultrasound-guided(US)percutaneous microwave ablation was performed on 22 patients with 24 uterine muscularis benign lesions(16 intramural,submucosal and subserosal myomas,8 uterine adenomyosis).CEUS was performed on 22 patients before,immediately after and 12-24 hours after treatment,and the enhanced pattern of all lesions was observed.The non-enhanced volumes was compared immediately and 12-24 hours after ablation.Results Before ablation,of all the 22 cases,14 cases of 16 uterine myomas exhibited peripheral enhancement pattern;8 adenomyosis lesions exhibited fast enhancement,the boundary of lesion and the surrounding muscle was not clear subsequently.Immediately after microwave ablation,the non-enhanced ablation areas of 19 lesions were spherical or irregular shaped with rough edges.Linear and flake enhancements were detected in the ablation area owing to the persistence of thermal field.Twelve to 24 hours after ablation,the ablated boundary of 17 lesions were relatively sharp,and the non-enhanced area was uniform.The ablation volume immediately after treatment(83.41±72.83)cm3 was smaller than the volume 12-24 hours after treatment(94.73±80.37)cm3,but they were not significantly different(t=1.138,P=0.267).Conclusions In percutaneous microwave ablation of uterine muscle benign lesions,the CEUS images exhibited distinct characteristics.CEUS within 12-24 hours after microwave ablation can accurately determine the scope of postoperative necrosis.