Value of three-dimensional contrast-enhanced ultrasonography in diagnosis of small adnexal masses: a preliminary study

Objective To evaluate the value of three-dimensional contrast-enhanced ultrasonography (3D-CEUS) in diagnosis of small adnexal masses.Methods Forty-three patients with 47 adnexal masses were examined by both two-dimensional contrast-enhanced ultrasound (2D-CEUS) and 3D-CEUS.Sonographic features of adnexal masses with 3D-CEUS were analyzed and compared with 2D-CEUS.All patients with adnexal masses were proved by operational pathology and long-term follow-up results.Results Enhancement from the periphery to the parenchyma, septa or papillae was shown by 2D-CEUS among 40 benign adnexal masses, and multicenter enhancement from parenchyma to the periphery among 7 malignant ones.There were significant differences in blood vessels of envelope and septa, and the enhancement of parenchyma between benign and malignant adnexal masses by 3D-CEUS (P ＜0.05).Straight and sparse blood vessels were seen inside benign solid masses.Enhancement was observed in the wall of cystic masses,but not in intracapsular structures.Dense and distorted vascularity was found inside malignant adnexal masses forming a ball in the parenchyma, which was significantly enhanced.Thick vasa vasorum was also visible in 6 out of 7 malignant ones.Conclusions 3D-CEUS has an advantage in displaying complex spatial vascular structures,and might be a new tool to study real vascular structures in small adnexal masses. Key words: Ultrasonography;  Microbubbles;  Adnexal diseases