Fig. 4

Three-dimensional and contrast-enhanced ultrasonography imaging. (a) Three-dimensional view on 3D realisticVue (Samsung Medical, Seoul, South Korea) shows multilocular signs resembling the “cosmos pattern” in MRI. (b) Three-dimensional reconstructed coronary section of uterus and cervix presented by the CrystalVue software (Samsung Medical, Seoul, South Korea). The enlarged barrel-shaped cervix with multilocular resonances and an uninvaded uterine cavity can be observed. (c) CEUS (PHILIPS EPIQ7, Philips Healthcare, Seattle, WA, the United States) examination on the blood perfusion of the cervical lesion. The ROI and curve in blue indicate the perfused region and TIC of the solid component in the cervix; the ROI and curve in orange represent the perfused region and TIC of the myometrium. The solid components of the cervical mixed echo began developing at the 7th second and peaked at the 22nd second, presenting a pattern of “quick-up and slow-down.” (d) Three-dimensional power Doppler (General Electric Company, Boston, Massachusetts, the United States) displays the increased blood supplies with irregular ramification, part of which multiplies and forms a clump-like pattern. Abbreviation CEUS, contrast-enhanced ultrasonography; CX, cervix; EN, endometrium; MRI, magnetic resonance imaging; ROI, region of interest; TIC: time-intensity curve