ABSTRACT
[Objective]To investigate the value of deep common iliac region lymphadenectomy in treatment of uterine malignancies.[Methods]88 patients with deep common iliac region lymphadenectomy in Third affiliated hospital of sun yat-sen university from March 2016 to June 2017 were enrolled in this study. The number of removed lymph nodes、metastatic lymph nodes、operative complication and so on were analyzed.[Results]The number of pelvic lymph nodes resection is from 18 to 52,the average is 26;the number of deep common iliac region lymph nodes resection is from 2 to 16,the average is 5. The number of pelvic lymph node metastasis is 11 and the rate is 12.5%;the number of deep common iliac region lymph node metastasis is 3,accounting for 27.3% of the total number of pelvic lymph node metasta-sis,which alone deep common iliac region lymph node positive in 1 case,9.0% of the total number of pelvic lymph node metastasis.The average operation time of single pelvic lymph node resection was 43 min and that of single deep common iliac region lymph nodes was 10 min.There was no severe complication.[Conclusion]Deep common iliac region lymphad-enectomy is feasibility and safety,27%of patients with pelvic lymph node metastasis has positive deep common iliac region lymph nodes,and we believe that the promotion and application of deep common iliac region lymphadenectomy can further improve the therapeutic effect of uterine malignancy.
ABSTRACT
<p><b>BACKGROUND</b>Ultrasound (US) is a popular method in the diagnosis and treatment of uterine leiomyomas, but the lack of accuracy greatly limits its application. Recently, microbubble enhancement technique affords direct depiction of tumor neovascularity and establishes a more precise vascular map of the tumor. This study was undertaken to describe the distribution patterns of SonoVue, a second-generation contrast agent, in the microcirculation of uterine leiomyomas, and to investigate the potential use of contrast-enhanced ultrasound (CEUS) in the characterization and treatment of uterine leiomyomas.</p><p><b>METHODS</b>Ninety-six patients with uterine leiomyomas were enrolled in this study. The CEUS was performed using cadence pulse sequencing technique (CPS) and SonoVue. Enhancement patterns of different lesions were observed. The diagnostic accuracy of CEUS was compared with that of conventional ultrasound.</p><p><b>RESULTS</b>After contrast injection, vessels of macro- and micro-circulation of the myoma first appeared, followed by the normal myometrium and finally the endometrium. During the washout phase, the myoma exhibited homogeneous enhancement followed by apparent hypoenhancement. The margin of the tumor was depicted clearly. There was no agent perfusion in the benign degenerative or necrotic area. However in sarcomas degeneration, the feeding vessels appeared markedly earlier than those in myometrium. In addition, the tumor exhibited heterogeneous hyperenhancment with no agent perfusion in the center and no membraniform sign was observed in the late phase. In subserous and submucous leiomyomas, the feeding arteries in the pedicle arising from the uterine could be seen. In this study, the diagnostic accuracy of CEUS and conventional US for uterine leiomyomas was 96.7% (160/165) and 82.4% (136/165) respectively.</p><p><b>CONCLUSIONS</b>CEUS can provide a precise description of the leiomyomas vascularization. The specific enhancement pattern may be helpful for the characterization, treatment choice and therapeutic monitoring of leiomyomas.</p>