Value Of Three-dimensional Contrast-enhanced Ultrasonography In Diagnosis Small Adnexal Masses

Objective: To investigate the value of three-dimensional contrast-enhancedultrasound (3D-CEUS) in diagnosis small adnexal masses (≤4cm). Methods:47patientswith51adnexal masses were examined by both two-dimensional contrast-enhancedultrasound (2D-CEUS) and3D-CEUS. Sonographical features of adnexal masses with3D-CEUS were analyzed and compared with2D-CEUS. A3D-CEUS scoring system wasproposed. All patients with adnexal masses were proved by operational pathology andlong-term follow-up results. Results:51small adnexal masses included43benign and8malignant ones.3D-CEUS clearly showed that the benign masses were balls or ball-likestructures composed of the capillary. Sparse distribution of blood vessels which were shortstraight strips or woven into mesh-like lightly enhanced in the benign masses. Irregularstereo structures with disordered and dense vascularity were showed inside malignantadnexal masses forming a ball in the parenchyma, which was significantly enhanced. Thescore of3D-CEUS in diagnosis small adnexal masses of every10seconds to90secondsafter the injection of contrast agents was noted down. There was no statistically significantdifference in the score of each group in20thsecond-70thsecond. The area under the20thsecond–70thsecond ROC curve was0.995maximally, and the cut-off score was8(≥8was malignant). The scoring system revealed a higher sensitivity of100%, specificity of98%, positive predictive value of89%, negative predictive value of100%, positivelikelihood ratio of43.00, negative likelihood ratio of0.00and accuracy of98%comparedwith2D-CEUS. Conclusion:3D-CEUS has an advantage in displaying complex spatialvascular structures compared with2D-CEUS, and might be a new tool to study realvascular structures in small adnexal masses.