静态超声弹性成像在子宫肌层良性病变微波消融效果评估中的应用  

The clinical value of ultrasound elastography in evaluating uterine leiomyomas and adenomyosis treated with percutaneous microwave ablation

作　　者：周洪雨[1] 张晶[1] 王芳[1] 韩治宇[1] 程志刚[1] 冯蕾[2] 李振彩[2] 陆兆龄 高娟[4] 

机构地区：[1]解放军总医院介入超声科,北京100853 [2]解放军总医院第一附属医院超声科 [3]美中互利公司临床应用部 [4]吉林省松原市吉林油田总医院功能科

出　　处：《中华超声影像学杂志》2012年第2期149-152,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金面上项目（81071156）

摘　　要：目的 探讨实时静态超声弹性成像在经皮穿刺微波消融治疗（PMAT）子宫肌层病变后即刻评价消融范围及形态的应用价值.方法 在行PMAT的150例患者中随机抽取18例（10例子宫肌瘤及8例子宫腺肌症）,分别于治疗前、治疗后即刻行实时静态超声弹性成像和静脉超声造影（CEUS）检查,并以术后1～2 d内增强MR为金标准,对比分析术后即刻静态超声弹性成像及CEUS评价消融范围的准确性.结果 PMAT后即刻静态超声弹性成像显示消融区呈与周围组织分界清晰的蓝色（质硬）,CEUS显示有效消融灶无造影剂增强.静态超声弹性成像、CEUS及增强MR测得的消融区均径分别为（4.90±1.12）cm,（4.64±0.93）cm,（4.89±1.02）cm.静态超声弹性成像测值略大于CEUS测值（P=0.02）,与增强MR测值差异无统计学意义（P=0.44）.结论 静态超声弹性成像可较准确地反映PMAT后即刻组织凝固坏死的范围,有望成为消融后即刻无创评价有效消融范围的方法.Objective To study the clinical value of ultrasound elastography in evaluating the ablated zone and morphology of uterine leiomyoma and adenomyosis treated with percutaneous microwave ablation treatment（PMAT） under ultrasound guidance.Methods Eighteen patients were randomly chosen from 150 patients with symptoms uterine leiomyomas or adenomyosis who were treated with PMAT.Contrastenhanced Ultrasound（CEUS） and ultrasound elastography were performed before and immediately after PMAT.Compared with contrast enhanced MR were performed at 1 - 2 d after PMAT,the accuracy of ultrasound elastography and CEUS in evaluating the ablated range of PMA were analysed.Results Ultrasound elastography showed that the ablated zone was blue and the boundary with the surrounding tissues was clear.The ablated zone showed no enhancement with CEUS and enhanced MR.The mean diameter of the ablated zone in ultrasound elastography,CEUS,and contrast enhanced MR was （4.90 ±1.12）cm,（4.64 ± 0.93） cm,and （4.89 ± 1.02） cm,respectively.The diameter in ultrasound elastography was slightly larger than that in CEUS （ P =0.02） and had no statistical difference with that in contrast enhanced MR （ P =0.44）.Conclusions Ultrasound elastography can accurately show the coagulation range immediately after PMAT and is supposed to be a method to evaluate the ablated zone noninvasively immediately after PMAT.

关 键 词：超声检查 微气泡 平滑肌瘤 腺肌瘤 微波/治疗应用 弹性成像 

分 类 号：R445.1[医药卫生—影像医学与核医学]