Contrast-enhanced ultrasound and tissue elastography in the differential diagnosis of primary and metastatic ovarian tumors in uterine cancer patients: our experience

Abstract

Objective: to study the possibilities of tissue elastography and contrast-enhanced ultrasound in the differential diagnosis of primary and metastatic ovarian tumors in uterine cancer patients.Materials and methods. The results of observations of 8 patients were analyzed.Results. We identified 8 patients with ovarian tumors, of whom 4 had synchronous primary cancers of the endometrium (synchronous group) and ovary and 4 had endometrial cancer with ovarian metastasis (metastasis group). Ovarian tumors in the synchronous group were more often unilateral, the structure of the ovarian tumor is more often multilocular-solid with uneven, clear contours, the size of the ovaries exceeds 6 cm, and the ovaries were mapped with 4 types of elastograms during tissue elastography. In this group dissemination of the process was not detected. Ovarian tumors in metastasis group were both bilateral and unilateral, represented by solid formations with clear, even contours, ovarian size did not exceed 6 cm, disseminated process was revealed in half of the cases (metastases in the greater omentum and in the retroperitoneal lymph nodes). With tissue elastography solidformations in the structure of the ovaries were mapped mainly by type 5 elastograms. With contrast-enhanced ultrasound in areas of a solid structure a rapid accumulation of the contrast agent in the arterial phase and its rapid excretion into the venous phase was revealed, only the contours of the walls and septum were visualized in the late phase with the multilocularsolid structure of the ovary.Conclusions. When we conduct an ultrasound examination of patients with a uterine cancer, a thorough study of the structure of the ovaries is important for timely diagnosis of the tumor. Further development of differential diagnostic criteria for macrometastases and synchronous ovarian tumors using modern ultrasound technologies is a promising task, since this information is necessary to correct the volume of surgery in this category of patients.

Keywords

• endometrial cancer
• primary multiple tumor
• ultrasound examination
• tissue elastography
• shear wave velocity
• strain ratio
• contrast-enhanced ultrasound