Comparison of the SMI Technique and CEUS for the Assessment of Microvasculature in Leiomyosarcoma and Its Clinical Value for Application

INTRODUCTION: To compare the ultrasonic flow imaging (SMI) and contrast-enhanced ultrasonography (CEUS) in evaluating leiomyoma microvessels and their clinical value. METHODS: 141 patients with uterine leiomyoma treated from March 2023 to March 2024 were retrospectively studied. They were divided into CEUS group (n = 70) and SMI group (n = 71) based on treatment-guiding methods. Blood flow parameters, blood flow grading, fibroid volume, volume reduction rate, and ablation rate were observed and compared. Kappa coefficients analyzed the consistency of blood-flow assessment, and Spearman's correlation analyzed the relationship between blood flow grading and parameters. RESULTS: Before treatment, no significant differences were found between the two groups (p > 0.05). After treatment, the SMI group had better results in blood flow parameters, grading, volume, reduction rate, and ablation rate (p < 0.05). The two methods had no significant difference in assessing blood flow grading after treatment (p > 0.05), but significant differences in assessing uterine fibroids. Their agreement on blood flow grading was general. Blood flow parameters were positively correlated with both groups (p < 0.05). DISCUSSION: Both SMI and CEUS can reflect fibroid microvessels and guide treatment, yet SMI is more effective, offering reference for clinical treatment selection.