Uterine disorders are often presented with overlapping symptoms. The microvasculature holds specific information important for diagnosing uterine disorders. Conventional sonography is an established diagnostic technique in gynecology, but is limited by its inability to image the microvasculature. Contrast-enhanced ultrasound (CEUS), is capable of imaging the microvasculature by means of intravascular contrast agents; that is, gas-filled microbubbles. We provide a literature overview on the use of CEUS in diagnosing myometrial and endometrial disorders, that is, fibroids, adenomyosis, leiomyosarcomas and endometrial carcinomas, as well as for monitoring and enhancing the effectiveness of minimally invasive therapies. A systematic literature search with quality assessment was performed until December 2020. In total 34 studies were included, published between 2007 and 2020.The results entail a description of contrast-enhancement patterns obtained from healthy tissue and from malignant and benign tissue; providing a first base for potential diagnostic differentiation in gynecology. In addition it is also possible to determine the degree of myometrial invasion in case of endometrial carcinoma using CEUS. The effectiveness of minimally invasive therapies for uterine disorders can safely and accurately be assessed with CEUS. In conclusion, the abovementioned applications of CEUS are promising and it is worth further exploring its full potential for gynecology by designing innovative and methodologically high-quality clinical studies.

Contrast-enhanced ultrasound (CEUS) is an innovative ultrasound technique capable of visualizing both the macro- and microvasculature of tissues. In this prospective pilot study, we evaluated the feasibility of using CEUS to visualize the microvasculature of uterine fibroids and compared CEUS with conventional ultrasound. Four women with fibroids underwent gray-scale ultrasound, sonoelastography and power/color Doppler scans followed by CEUS examination. Analysis of CEUS images revealed initial perfusion of the peripheral rim, that is, a pseudo-capsule, followed by enhancement of the entire lesion through vessels traveling from the exterior to the interior of the fibroid. The pseudo-capsules exhibited slight hyper-enhancement, making a clear delineation of the fibroids possible. The centers of three fibroids exhibited areas lacking vascularization, information not obtainable with the other imaging techniques. CEUS is a feasible technique for imaging and quantifying the microvasculature of fibroids. In comparison with conventional ultrasound imaging modalities, CEUS can provide additional diagnostic information based on the microvasculature.

or more fibroids. Mean size of the fibroids was 23.7 mm (range 14-37 mm). All fibroids were type 2 (FIGO) except one type 0 and one type 1. Hysterosonography and hysteroscopic score was 4.22 in both groups with no statistically significant differences (p < 0.001). Hysterosonography score was low (group I) in 4 patients (44.4%) and intermediate (group II) in 5 women (55.5%), ranging from 1-6. Hysterosocopy score was identical but ranging from 0-6. There were no statistically significant differences between both groups (p < 0.001). Hysterosonography prediction of complexity was well correlated with hysteroscopy except for one case. Conclusions: 3D Hysterosonography is a good diagnostic tool for evaluating submucosal fibroids that can help in the decision-making of these patients. Hysterosonography can be used to predict the complexity of hysteroscopic resection of fibroids. More studies are needed to confirm these findings. VP63.08 Ultrasonographic parameters predicting the improvement of postmenstrual spotting in patients undergoing hysteroscopic treatment of isthmocele

or more fibroids. Mean size of the fibroids was 23.7 mm (range 14-37 mm). All fibroids were type 2 (FIGO) except one type 0 and one type 1. Hysterosonography and hysteroscopic score was 4.22 in both groups with no statistically significant differences (p < 0.001). Hysterosonography score was low (group I) in 4 patients (44.4%) and intermediate (group II) in 5 women (55.5%), ranging from 1-6. Hysterosocopy score was identical but ranging from 0-6. There were no statistically significant differences between both groups (p < 0.001). Hysterosonography prediction of complexity was well correlated with hysteroscopy except for one case. Conclusions: 3D Hysterosonography is a good diagnostic tool for evaluating submucosal fibroids that can help in the decision-making of these patients. Hysterosonography can be used to predict the complexity of hysteroscopic resection of fibroids. More studies are needed to confirm these findings. VP63.08 Ultrasonographic parameters predicting the improvement of postmenstrual spotting in patients undergoing hysteroscopic treatment of isthmocele