增强T2血管加权成像在子宫腺肌病诊断及评估高强度聚焦超声治疗的初步研究  

The value of ESWAN in diagnosis of adenomyosis and evaluation of HIFU ablation therapy:the preliminary study

作　　者：程启超 王燕鸣 李菲 王锡臻[1] 王滨[2] 沈蓁[1] CHENG Qichao;WANG Yanming;LI Fei;WANG Xizhen;WANG Bin;SHEN Zhen(Affiliated Hospital of Weifang Medical College,Weifang 261053,China;不详)

机构地区：[1]潍坊医学院附属医院,山东潍坊261053 [2]滨州医学院影像医学影像学研究所,山东烟台264033

出　　处：《实用医学杂志》2020年第17期2424-2427,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81641074,81171303,30470518,81771828);山东省自然科学基金(编号:ZR2009CL046,ZR2010HQ029,ZR2016HL40,ZR2017MH037);山东省优秀中青年科学家科研奖励基金(编号:BS2012YY038);潍坊医学院博士科研启动资金(2009);潍坊医学院大学生科技创新基金(编号:KX2015011,KX2016038,KX2017041,KX2019085);山东省医药卫生科技发展计划(编号:2017WS408,2017WS579);山东省大学生科研项目(编号:S201910438022);潍坊市科技发展计划项目(编号:2017YX054,2017YX017);山东省高校科研计划项目(科技类)(编号:J18KA288,J18KA284)。

摘　　要：目的分析正常子宫肌层、高强度聚焦超声(HIFU)治疗子宫腺肌病(AM)前后增强型T2加权血管成像(ESWAN)参数值,探讨ESWAN在AM的诊断及评估HIFU治疗的应用价值。方法分析44例经HIFU治疗AM患者及40例志愿者磁共振平扫,增强及ESWAN序列资料。记录AM治疗前后及子宫肌层幅度值、相位值、R2值和T2值,分析ESWAN不同参数在AM中的诊断价值及评估HIFU治疗的效果。结果子宫肌层幅度值、相位值、R2值和T2值分别为(1652.36±425.66)、(0.032±0.060)、(22.35±5.17)、(43.26±9.36)。AM患者HIFU治疗前后幅度值分别为(1242.47±346.81)和(1402.22±279.98),相位值为(0.014±0.044)和(0.020±0.039)、R2值为(26.30±2.59)和(23.15±2.40)、T2值为(39.60±4.23)和(41.71±4.72)。AM患者HIFU治疗前的幅度值和T2值均低于子宫肌层(P<0.05、0.027),R2值降低(P<0.05);相位值低于子宫肌层(P=0.108),但差异无统计学意义。HIFU治疗后,幅度值和T2值升高(P<0.05),R2值降低(P≤0.05);相位值升高(P=0.249),但差异无统计学意义。结论ESWAN在一定程度反映子宫腺肌病病变区及肌层间的信号差异,同时能够反应AM患者HIFU治疗后的组织学变化。Objective By analyze the value of enhanced T2 star-weighted angiography(ESWAN)in thenormal myometrium and adenomyosis(AM),before and after the treatment of AM with high intensity focus ultra-sound(HIFU),to explore the diagnostic value of ESWAN parameters and the effect of HIFU treatment.Methods Conventional MRI,contrast enhanced and ESWAN were performed on forty-four clinically diagnosed AM patients,and forty normal adult women.The ESWAN indices include magnitude value,phase value,R2 value and T2 valuewere measured on normal myometrium,before and after HIFU treatment.ResultsThe normal myometrium magni-tude value,phase value,R2 value and T2 value were(1652.36±425.66),(0.032±0.060),(22.35±5.17),(43.26±9.36);the magnitude values of AM before and after HIFU treatment were(1242.47±346.81)and(1402.22±279.98),phase values were(0.014±0.044)and(0.020±0.039),R2 values were(26.30±2.59)and(23.15±2.40),and T2 values were(39.60±4.23)and(41.71±4.72).The magnitude value and T2 value ofAM were lower than those of normal myometrium(P<0.05);while R2 value was higher(P<0.05);there was no sta-tistical difference of phase value between AM and normal myometrium(P=0.108).After HIFU,magnitude valueand T2 value were increased(P<0.05);R2 value was decreased(P<0.001);there was no statistical difference ofphase value between before and after HIFU treatment(P=0.249).ConclusionsESWAN can show the differencesbetween normal myometrium and AM,and evaluate the histological characteristics after HIFU treatment.

关 键 词：子宫腺肌病 磁共振 增强T2加权血管成像 高强度聚焦超声 

分 类 号：R445.2[医药卫生—影像医学与核医学]