超声造影及三维彩色能量成像在射频消融治疗子宫肌瘤中的应用价值  

Application value of contrast-enhanced ultrasound and three-dimensional color power angiography in the treatment of radiofrequency ablation for uterine fibroids

作　　者：吕倩[1] 董晓秋[1] 

机构地区：[1]哈尔滨医科大学附属第四医院超声科,哈尔滨市150001

出　　处：《临床超声医学杂志》2017年第5期293-296,共4页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(81271646)

摘　　要：目的探讨超声造影(CEUS)及三维彩色能量成像(3D-CPA)指导射频消融治疗子宫肌瘤的应用价值。方法选取98例拟行射频消融治疗的子宫肌瘤患者,随机分为CEUS组46例和3D-CPA组52例。CEUS组术前行超声造影检查,记录达峰期肌瘤增强程度;3D-CPA组术前行三维超声成像检查,记录肌瘤血流分级情况及供血血管走行,两组术后均行超声造影检查,比较术后2 h肌瘤完全消融率,以及两组内术前和术后3个月的肌瘤体积缩小率。结果两组术前高增强与Ⅲ级血流信号、等增强与Ⅱ级血流信号的病灶射频消融治疗后2 h完全消融率比较差异无统计学意义,低增强与Ⅰ级血流信号的病灶完全消融率比较差异有统计学意义(P<0.05)。术后3个月两组内肌瘤平均体积缩小率下降,差异均有统计学意义(均P<0.05),但两组间术后平均体积缩小率比较差异无统计学意义。结论 3D-CPA和CEUS均能较好地指导具有丰富血管的肌瘤进行射频消融,但3D-CPA成像对细小血管的显示低于CEUS。Objective To investigate the application value of contrast-enhanced ultrasound（CEUS） and three-dimensional color power angiography（3D-CPA）in the treatment of radiofrequency for uterine fibroids. Methods Ninty-eight cases of patients with uterine fibrods plan for radiofrequency ablation therapy were selected,and divided into two groups randomely,46 cases were put into CEUS group and 52 cases were put into 3D-CPA group.The CEUS was performed on patients in CEUS group before radiofrequency ablation,degree of enhancement when enhanced to the peak was recorded.The three-dimensional ultrasound was performed for patients in 3D-CPA group,fibroids blood flow classification and blood vessels direction were recorded.The CEUS was performed for patients in two groups.The ablation rate at the time of 2 h after operation was compared between two groups,and the shrinkage rate at 3 months after operative was compared between two groups,respectively.Results No significanct difference for ablation rate was found between two groups,for lesions evaluated preoperatively as hyperenhancement,level Ⅲ blood flow,neither lesions with iso-enhancement and level Ⅱ blood flow.However,significant difference was found between two groups for lesions evaluated preoperatively as hypo-enhancement and level Ⅰ blood flow（P〈0.05）. The shrinkage rate of uterine fibroids declined gradually,the differences between two groups was statistically different（P〈0.05）,but no difference was found between the same group. Conclusion Both 3D-CPA and CEUS can guide the radiofrequency ablation for fibroids with rich blood vessels inside,for showing mini-vasculatrures,CEUS is much better than 3D-CPA.

关 键 词：超声检查 造影剂 能量成像 彩色 三维 射频消融 子宫肌瘤 

分 类 号：R737.33[医药卫生—肿瘤] R445.1[医药卫生—临床医学]