Contrast-Enhanced Ultrasonography in Sclerotherapy for Ovarian Endometrial Cyst

We investigated contrast-enhanced ultrasonography (CEUS) characteristics related to the perfusion pattern and parameters of the time−intensity curve of ovarian endometrial cysts (OECs) pre- and post-sclerotherapy. Forty-three patients with one-sided, single, untreated OECs underwent CEUS pre- and post-sclerotherapy. OEC wall thickness was measured by 2-D ultrasonography and CEUS, and CEUS enhancement patterns and time−intensity curve parameters before and after sclerotherapy were compared. OEC wall thickness remained essentially unchanged post-sclerotherapy. Wall thickness was significantly larger on 2-D ultrasonography than on CEUS. The OEC wall exhibited rapid enhancement and slow clearance both pre- and post-sclerotherapy. Wash-in and wash-out times remained unchanged. The wall exhibited iso-enhancement pre-sclerotherapy, but low and partially uneven enhancement post-sclerotherapy. Post-treatment, time to peak was delayed, peak intensity was reduced and perfusion slope was decreased. The contrast agent arrival time and area under the curve remained similar. CEUS enhancement patterns and quantitative parameters were altered post-sclerotherapy; thus, treatments involving sclerosing agent retention can help to improve the efficacy of sclerotherapy for OEC.