Use of contrast-enhanced ultrasound in evaluating the efficacy and application value of microwave ablation for adenomyosis

Abstract

Aim: This study aims to assess the use of contrast-enhanced ultrasonography (CEUS) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the evaluation of percutaneous microwave ablation (PMWA) of localized adenomyosis.

Materials and methods: Sixty-six patients with single-onset adenomyosis who underwent PMWA at the Liaocheng Tumor Hospital of Shandong Province from January 2013 to February 2019 were enrolled. Venous CEUS and DCE-MRI examinations were performed before and 1-2 days after the surgery. The ablation rates calculated by CEUS and DCE-MRI were compared and analyzed for accuracy.

Results: After microwave ablation (MWA), CEUS showed that the volume and ablation rate of the ablated zone were 52.03 ± 28.39 cm3 and 90.90% ±6.61%, respectively. By DCE-MRI, the ablation volume and ablation rate of adenomyosis were 52.20 ± 28.65 cm3 and 90.88% ±6.32%, respectively. Dysmenorrhea was significantly relieved within 3 months of the operation, and nonmenstrual hemoglobin levels were significantly improved at 3 and 6 months after the operation (P < 0.05). All 66 cases of adenomyosis were treated using PMWA. Postoperatively, 17 patients reported a change in vaginal fluid; however, no special treatment was required as this disappeared 2-11 days after surgery.

Conclusions: CEUS can accurately evaluate the ablation rate of localized adenomyosis treated with MWA, which is consistent with DCE-MRI. It is convenient and easy to perform ablation of adenomyomas, with incomplete ablation and angiography, and is a method worthy of clinical promotion.

Keywords: Adenomyosis; contrast agent; magnetic resonance imaging; microwave ablation; ultrasound.