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Возможности эхопозитивного контрастирования при ультразвуковой диагностике изменений миометрия

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Advantages of Sonopositive Contrast Enhancement for the Ultrasonic Diagnostics of Myometrium Pathology

A precise, harmless and inexpensive tool for visualization of the myometrial abnormalities at endometriosis and post-operative uterine scars is described in detail. Persistent long-lasting enhancement of wall defects in an uterine and endometriotic tracks is based on the capacity of hydrogen peroxide solution to dissociate with oxygen isolation. Gas microbubbles exaggerate the sonopositive image of the filled areas and make possible to observe the contrast agent passages by the 2D gray scale, pulsed and color Doppler regimes. During preliminary routine uterine ultrasonography the uterine cavity length and width are estimated and its maximal volume is calculated according to our own formula. An appropriate volume of 0,15–0,33% hydrogen peroxide solution is injected at once by syringe within cervical channel and uterine cavity. For the perfect penetration and visualization of endometriotic tracks the additional doses of the contrast agent are injected during 30–40 sec and its outflow is prevented during 1–2 min. During consecutive transabdominal or transvaginal ultrasonography one can estimate and record in real time the images of cervical channel and uterine cavity borders, as well as of submucous nodes, endometrial polyps, endometriotic tracks, and other myometrial abnormalities. According to the prevalence and depth of contrast medium penetration into myometrium one can make the conclusion about the localization, degree, and form (diffuse or focal) of endometriosis. It is of special importance if endometriotic process is localized in corneal regions of the uterus, which may be a cause for an infertility and tubal pregnancy. The contrast enhancement of uterine postoperative scar gives an opportunity for more precise measure of the myometrial thickness and for evaluation of its structure in scar area in order to make a conclusion about vaginal birth. If uterine tubes are patency the sonopositive visualization of perimetrium takes place. So, one can evaluate the true

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