Novel use of contrast-enhanced sonography in the diagnosis of central uterine necrosis following embolization for postpartum hemorrhage.
Since 2007, we have identified 2 cases of central uterine necrosis after uterine arterial embolization for postpartum hemorrhage. Contrast-enhanced sonography showed an absence of enhancement of the internal myometrium. Magnetic resonance imaging with gadolinium confirmed the diagnosis. The images obtained for the first case were corroborated by histologic analysis from a hysterectomy done for sepsis. For the second case, contrast-enhanced sonography performed during a follow-up period of conservative treatment revealed a reduction of necrosis. Our study shows that contrast-enhanced sonography seems to be a useful examination as an adjunct to grayscale and power Doppler imaging in the diagnosis and follow-up of uterine necrosis.
MS, Service de Gynécologie, Hôpital Bretonneau, 2 Boulevard Tonnelé, 37000 Tours, France. l.ouldamer@chu-tours.fr.
Hélène
H
Desille
Lobna
L
Ouldamer
Aurore
A
Bleuzen
Flavie
F
Arbion
Denis
D
Herbreteau
Henri
H
Marret
D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D009336:Necrosis / Q000175:diagnosis / Q000209:etiology; D010743:Phospholipids / Q000008:administration & dosage; D006473:Postpartum Hemorrhage / Q000000981:diagnostic imaging* / Q000628:therapy*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D014463:Ultrasonography / Q000379:methods*; D014599:Uterus / Q000000981:diagnostic imaging* / Q000473:pathology*
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
SonoVue; contrast-enhanced sonography; embolization; postpartum hemorrhage; uterine necrosis