Comparison of Contrast-Enhanced Ultrasound Versus Magnetic Resonance Imaging in the Detection and Characterization of Uterine Leiomyomas

J Ultrasound Med. 2021 Jun;40(6):1147-1153. doi: 10.1002/jum.15495. Epub 2020 Sep 15.

Abstract

Objectives: Uterine fibroids are common findings in women with pelvic pain and abnormal uterine bleeding. The reference standard test in the pretreatment evaluation of fibroids is contrast-enhanced magnetic resonance (MR) imaging. This study compared the number, size, location, and enhancement of uterine fibroids identified by contrast-enhanced ultrasound (CEUS) and MR. The aim of this study was to demonstrate that CEUS performs similarly to MR and could be used as an alternative imaging modality.

Methods: In this prospective observational study, 26 women underwent transabdominal CEUS and MR examinations. Blinded to the original clinical MR interpretations, 2 readers reviewed the MR and CEUS studies for each patient. The number, size, location, and enhancement of each fibroid per patient were reported by MR and CEUS. A Pearson correlation coefficient was calculated for the number of fibroids identified by each modality.

Results: In total, 126 fibroids were imaged: 115 (91.3%) were observed on both examinations; 9 (7.1%) were observed by MR only; and 2 (1.6%) were observed by CEUS only. A high correlation was found between the modalities for the number of fibroids identified per patient (r = 0.97; P < .001). There was also no significant difference between the modalities for each patient in the fibroid number, size, location, or enhancement.

Conclusions: These findings suggest that transabdominal CEUS may represent an alternative to MR in pretreatment evaluation of uterine fibroids and could serve as a test of choice in patients with a contraindication to MR.

Keywords: contrast-enhanced ultrasound; fibroids; leiomyomas; magnetic resonance imaging.

Publication types

  • Observational Study

MeSH terms

  • Female
  • High-Intensity Focused Ultrasound Ablation*
  • Humans
  • Leiomyoma* / diagnostic imaging
  • Magnetic Resonance Imaging
  • Prospective Studies
  • Treatment Outcome
  • Ultrasonography
  • Uterine Neoplasms* / diagnostic imaging