高强度聚焦超声消融术治疗不同影像学病理类型子宫肌瘤疗效比较  

Efficacy Comparison of High Intensity Focused Ultrasound Ablation in he Treatment of Uterine Fibroids among Different Imaging Pathological Types

作　　者：徐海飞[1] 章春来[1] 张菁菁[1] 张婧[1] XU Haifei;ZHANG Chunlai;ZHANG Jingjing;ZHANG Jing(The People's Hospital of Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市人民医院,浙江丽水323000

出　　处：《浙江医学教育》2020年第2期45-47,53,共4页Zhejiang Medical Education

摘　　要：目的:比较高强度聚焦超声消融术(HIFU)治疗不同影像病理类型子宫肌瘤的疗效。方法:选择接受HIFU治疗的62例子宫肌瘤患者(95个肌瘤),根据MRI影像病理类型分为普通型(n=40)、退变型(n=31)和富于细胞型(n=24)。比较不同影像病理类型的子宫肌瘤患者治疗参数及超声图像。结果:富于细胞型的肌瘤体积大于普通型、退变型(P<0.05);与普通型比较,退变型、富于细胞型肌瘤的治疗时间延长,EEF增大,NPV及消融率下降,富于细胞型EEF高于退变型(P<0.05);团状回声出现时的治疗时间在普通型、退变型、富于细胞型肌瘤中依次延长(P<0.05);普通型、退变型团状回声出现率高于富于细胞型(P<0.05)。结论:子宫肌瘤组织病理成分差异是影响HIFU消融效果重要原因,普通型相对容易消融,富于细胞型消融相对困难。[Objective]To comparatively analyze the high intensity focused ultrasound ablation(HIFU)in the treatment of uterine fibroids among different imaging pathological types.[Method]62 cases(95 fibroids)of uterine fibroids treated with high HIFU were selected,which were divided into common type(n=40),degenerative type(n=31)and cell abound type(n=24)according to the pathological types of MRI.The treatment parameters and ultrasonic image changes of patients with uterine fibroids of different imaging pathological types were compared.[Result]The size of fibroids with cell abound type was larger than that of common and degenerative type(P<0.05).Compared with common type,the treatment time,EEF,NPV and ablation rate of degenerative type and cell abound type were longer,and the EEF,NPV and ablation rate of degenerative type and cell abound type were longer than those of common type(P<0.05).The treatment time of appearance of mass echo was prolonged successively in common type,degenerative type,and cell abound type(P<0.05).The occurrence rate of mass echo in common type and degenerative type was higher than that of cell abound type(P<0.05).[Conclusion]The MRI signal intensity of uterine fibroid tissue is related to the pathological components of fibroid tissue.The difference in the pathological components of uterine fibroid tissue is an important reason affecting the effect of HIFU ablation.The common type is relatively easy to be ablated,while the cellular type is relatively difficult to be ablated.

关 键 词：高强度聚焦超声消融术 子宫肌瘤 影像学病理类型 

分 类 号：R445.1[医药卫生—影像医学与核医学]