Parametric mapping of contrasted ovarian transvaginal sonography

Ultrasonography of the normal reproductive tract of the female domestic cat

The objective of this study was (1) to describe the US appearance and obtain reference values for the uterus and ovaries in nongravid and gravid queens with histologically confirmed reproductive tracts without disorders, (2) to provide US measurements of the reproductive tract compared to gross macroscopic and water-bath post-OVH US measurements in nongravid queens, and (3) to describe the sonographic appearance of the female reproductive tract during the different histopathologic phases of the reproductive cycle in nongravid and gravid queens. Ninety-three queens from a "trap, neuter, return" program were included in this study. Sonographic evaluation of the reproductive tract was performed in all queens, and measurements of the corpus uteri, uterine horns, and ovaries were recorded. Following OVH, macroscopic measurements were obtained, and a water-bath US evaluation of these tissues and measurements was recorded. Samples from the corpus uteri and both the uterine horns and ovaries were collected for histopathologic examination after all measurements had been recorded. Seventy-two reproductive tracts met the inclusion criteria by having a histopathologically confirmed normal reproductive tract. Sixty-three queens were nonpregnant and 9 were pregnant. The ovaries and uterus were sonographically visible in all queens regardless of reproductive status. The ovaries were ovoid in shape, and the uterus appeared as a tubular structure with distinct wall layers (serosa and indistinct myometrium and myometrium, or serosa, myometrium, and endometrium), with variable echogenicity of the inner layers. The layering of the uterine wall, observed during the second half of pregnancy, was described. Ovarian follicles were visible in 66/72 (92%) cats. However, the CL was only visible in 40/72 (55%) cats. The reference values of the left ovarian length, right ovarian length, uterine horn diameter, and uterine body are 7.1-13.9, 7.3-13.6, 1-5.8, and 1.5-5.3 mm, respectively, in a nongravid uterus. The uterine wall thickness during pregnancy varied from 2.4 to 6.8 mm. There was a significant positive correlation between US measurements obtained in vivo and those obtained macroscopically and in a water bath post-OVH. The body weight, follicular size, sonographic visibility of the uterine wall layering, the histopathologic luteal phase, and the active/inactive status on histopathology had a significant effect on the uterine measurements (p < 0.05). It was not possible to describe the exact US features of the reproductive tract during the different histopathologic phases. In conclusion, ultrasonographic reference values for the normal female reproductive tract in cats were determined. The results of this study indicated that the ovaries and uterus were visible in cats regardless of reproductive status.

Combination of serum CA19-9 and CA125 levels and contrast-enhanced ultrasound parametric data facilitates to differentiate ovarian serous carcinoma from ovarian malignant epithelial cancer

Ovarian serous carcinoma (OSC) is semimalignant ovarian tumors that localized in the ovary at the initial presentation, and can be surgically resected in an excellent prognosis. In contrast, surgical treatment plus adjuvant chemotherapy for ovarian malignant epithelial cancer (OMEC) is the standard treatment stratagem that is painful with poor prognosis and cost quite expensively. Thus, the accurate preoperative differentiation of OSC from OMEC is important for determining the treatment methods and decreasing the cost for individual patients. This study aims to determine whether contrast enhanced ultrasound (CEUS) together with CA19-9/CA125 can improve the ability to differentiate ovarian serous carcinoma from ovarian malignant epithelial cancer. The positive rate of cancer antigen (CA) 199 and CA125 in ovarian malignant epithelial tumors was 68% and 94%, respectively, which was a higher incidence than in the serous carcinoma. The mean serum CA19-9 and CA125 concentration was significantly higher in the patients with ovarian malignant epithelial tumors (CA19-9, 514.0 ± 104.8 U/mL; CA125, 440.0 ± 154.8 U/mL) than that in the patients with ovarian serous carcinoma (CA19-9, 58.0 ± 14.3 U/mL; CA125, 63.0 ± 25.8 U/mL). The time to peak in ovarian serous carcinoma was significantly longer than in ovarian malignant epithelial tumors. However, the peak intensity, area under the curve, and washout time in ovarian serous carcinoma were significantly lower than in ovarian malignant epithelial tumors. The addition of CA19-9/CA125 increased the sensitivities from 79% CEUS only to 85% for CEUS plus CA19-9/CA125 data, and increased the specificities from 65% CEUS only to 91% for CEUS plus the CA19-9/CA125 information. Thus, the addition of the serum CA19-9/CA125 levels to parametric CEUS data was of significant diagnostic value for differentiating OSC from OMEC.