超声造影评价高强度聚焦超声治疗子宫腺肌病效果  

Evaluation of contrast-enhanced ultrasound in treatment of ultrasound-guided high intensity focused ultrasound ablation for uterine adenomyosis

作　　者：秦瑞英[1] 王艳敏[1] 华彩虹[1] 王世进[1] 侯瑞杰[1] 郭会敏[1] 

机构地区：[1]新乡医学院第一附属医院妇产科海扶治疗室,河南卫辉453100

出　　处：《重庆医学》2014年第21期2722-2724,共3页Chongqing medicine

摘　　要：目的：评价超声造影（CEUS）在高强度聚焦超声（HIFU ）消融治疗子宫腺肌病过程中实时判断效果的应用及价值。方法2013年1～9月，将临床确诊的67例子宫腺肌病患者纳入本研究，其中弥散型腺肌病患者49例，局限型18例。在超声治疗前、治疗中及治疗后即刻行CEUS ，明确病灶情况及行消融效果评价。结果67例患者术前CEUS ，病灶及子宫明显灌注率100％；15例（22．4％）患者第一次结束治疗后行CEUS ，消融欠满意，继续治疗；所有患者在最终治疗结束后CEUS显示全部患者出现凝固性坏死。术中42例（62．7％）出现整体灰度变化，25例（37．3％）出现团块状灰度变化。HIFU术中CEUS能清楚显示腺肌病灶及治疗后的非灌注区。CEUS检查示治疗前病灶最大径、病灶体积、非灌注区体积、腺肌病灶消融率分别为（4．8±1．5）cm、（63．1±57．2）cm3、（59．1±53．4）cm3、（76．4±27．0）％。术中出现的所有不良反应与CEUS无关。结论 CEUS是一种准确评价HIFU消融效果的方法，可安全用于HIFU术中实时评价子宫腺肌病消融效果。Objective To evaluate the effect of contrast-enhanced ultrasound（CEUS） in the real-time monitoring treatment of ultrasound-guided high intensity focused ultrasound （HIFU ） for uterine adenomyosis .Methods From January 2013 to September 2013 ,a total of 67 patients who were clinically diagnosticated as uterine adenomyosis were enrolled in this study .49 patients were diffuse type and 18 patients were localized .CEUS was used before ,in ,after ultrasonic treatment to make sure lesions and evaluate the ablation effect .Results 67 patients were 100% perfused before HIFU treatment by CEUS ,the non-perfused volume ratio of 15 patients（22 .4% ） were not enough during treatment ,and more energy were given .During HIFU treatment ,uniform grey scale change was observed in 42 of 67（62 .7% ） patients and massive grey scale change was observed in 25 of 67（37 .3% ） patients .The margin of targets and the non-perfused volume were clearly detected by CEUS .The size of target andymyosis ,the volume ,the non-perfused volume ,and non-perfused volume ratio were（4 .8 ± 1 .5）cm ,（63 .1 ± 57 .2）cm3 ,（59 .1 ± 53 .4 ）cm3 ,（76 .4 ± 27 .0）% .The adverse effects occurred in the treatment were not related to CEUS .Conclusion CEUS is an accurate method in assessing the treat-ment effect of HIFU and could be safely used during HIFU treatment for uterine adenomyosis .

关 键 词：高强度聚焦超声消融 子宫腺肌 超声造影 

分 类 号：R711.71[医药卫生—妇产科学]