Ultraschall Med 2005; 26 - P093
DOI: 10.1055/s-2005-917593

THE USEFULNESS OF CONTRAST ENHANCED ULTRASONOGRAPHY IN PATIENTS WITH UTERINE MYOMA BEFORE AND AFTER UTERINE ARTERY EMBOLIZATION

T Satoh 1, K Koito 1, N Hirokawa 1, M Nishida 2, Y Kawaai 1, T Shounai 1, M Someya 1, N Yama 1, H Hyodo 1, M Hareyama 1
  • 1Radiology, School of Medicine, Sapporo Medical University
  • 2Radiation Oncology, Imaging and Diagnosis, Sapporo Medical University Graduate School of Medicine, Sapporo, Japan

Purpose: The aim of our study was to investigate usefulness of contrast enhanced ultrasonography (CEUS) for estimating uterine vasculization before and after uterine artery embolization (UAE).

Methods and Materials: Four patients (age range, 43 to 49 years; mean age, 46 years) with uterine myoma were enrolled in this study. All the patients underewent CEUS before and after UAE (approximately several days and 3 months after UAE). UAE was performed via the bilateral femoral arteries. We inserted the 4 Fr. cather into the bilateral uterine arteries, and occluded those arteries with the sliced gelatin sponge. The CEUS method adopted was wide band Doppler technique (Advanced Dynamic Flow) by using an ultrasound equipment “Aplio“ (Toshiba, Tokyo, Japan). We administered Levovist (Schering, Germany) (400mg/ml, total volume 7ml) via the antecubital vein with bolous hand injection.We observed perfusion of the uterine wall and the myomas by flash echo imaging at both the vascular phase (20–40seconds after injection) and the parencymal phase (60–80 seconds after injection).

Results: After UAE, all of the patients showed no symptomes such as abdominal distension, pollakiuria, and hypermenorrhea. We could encounter no hazardous complications of CEUS. Before UAE, both myomas and uterine muscular wall showed hypervascularity in all cases with CEUS. However, myomas after UAE revealed no tumoral enhancement. On the contrary, uterine muscular wall of all patients showed wall enhancement even after UAE. Those results could be obatined at both several days and 3 months after UAE.

Conclusions: From those results, we concluded that CEUS can evaluate the therapeutic efficacy of UAE more easily and safely than enhanced CT. In addition, it does not raise medical cost compared with MRI. CEUS should be the initial technique for evaluation of UAE.