增强MRI在高强度聚焦超声治疗子宫肌瘤疗效的评估价值  

Value of contrast-enhanced MRI in evaluating therapeutic efficacy of high-intensity focused ultrasound in treatment of uterine myoma

作　　者：马婉玲 赵萌[2] 曾铭[3] 

机构地区：[1]第四军医大学第一附属医院(西京医院)放射科,陕西省710032 [2]南京医科大学第一附属医院放射科 [3]延安市人民医院CT诊断科

出　　处：《江苏医药》2016年第23期2569-2572,I0001,共5页Jiangsu Medical Journal

摘　　要：目的探讨增强MRI评估高强度聚焦超声(HIFU)治疗子宫肌瘤疗效的价值。方法65例患者(105个肌瘤)在HIFU治疗前后行增强MRI检查,分析肿瘤体积、信号以及强化情况,并比较不同类型和位置肿瘤间的疗效差异。结果 HIFU治疗后1个月,89个肌瘤体积缩小、强化减低,凝固性坏死发生率为65.7%,有效率为88.6%。HIFU治疗后6个月,84个肌瘤体积缩小、强化减低,凝固性坏死发生率为41.9%,有效率为83.8%。前壁肌瘤治疗有效率高于后壁及宫底肌瘤(P<0.05)。浆膜下与肌壁间子宫肌瘤治疗有效率比较无统计学差异(P>0.05)。结论采用HIFU治疗子宫肌瘤的总体有效率较高,增强MRI可反映瘤灶大小和灌注情况,有效评价治疗效果。Objective To investigate the clinical value of contrast-enhanced MRI in evaluating the therapeutic efficacy of high-intensity focused ultrasound （HIFU ） in the treatment of uterine myoma .Methods A total of 105 uterine myomas in 65 patients was treated by HIFU ,which were examined with contrast-enhanced MRI before and after HIFU treatment .The changes of tumor volume ,signal and intensity were analyzed ,and the efficacy was compared among different types and locations of the uterine myomas .Results The contrast-enhanced MRI results showed that ,one month after HIFU treatment ,the volume and intensity of 89 myomas were decreased ,and the incidence rate of coagulation necrosis and effective rate were 65 .7% and 88 .6% ,respectively .In 6 month after HIFU treatment ,the volume and intensity of 84 myomas were decreased ,and the incidence rate of coagulation necrosis and effective rate were 41 .9% and 83 .8% ,respectively .The effective rate of myomas located in anterior wall of the uterus was significantly higher than that in posterior wall and fundus uteri（P〈0 .05） .There was no statistical difference in effective rate between subserous and intramural myomas （ P〉0 .05 ） .Conclusion HIFU in the treatment of uterine myoma achieves a higher effective rate .Contrast-enhanced MRI is a potential tool for reflecting the changes of boundary , volume and blood perfusion of uterine myoma and effectively evaluating the clinical outcomes of treating uterine myoma with HIFU .

关 键 词：增强磁共振成像 高强度聚焦超声 子宫肌瘤 

分 类 号：R445[医药卫生—影像医学与核医学]