磁共振动态增强扫描与弥散加权成像结合血清Ca125对高强度聚焦超声治疗子宫腺肌病的疗效评价  

Evaluation of dynamic enhanced magnetic resonance scanning and diffusion weighted imaging combined with Ca125 in the treatment of adenomyosis by high-intensity focused ultrasound

作　　者：杨进军[1] 鲁辛健 王晓燕[1] 班允清[1] 刘雁林[1] Yang Jinjun;Lu Xinjian;Wang Xiaoyan;Ban Yunqing(CT Nuclear Magnetic Resonance Room,the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第五附属医院CT核磁室,乌鲁木齐830011

出　　处：《中华保健医学杂志》2022年第4期325-328,共4页Chinese Journal of Health Care and Medicine

基　　金：新疆维吾尔自治区自然科学基金(2020D01C221)。

摘　　要：目的探讨磁共振动态增强及弥散加权成像相关参数结合血清Ca125对于评价高强度聚焦超声治疗子宫腺肌病早期疗效的价值。方法选取2021年1月~2021年12月新疆医科大学第五附属医院收治的32例子宫腺肌疾病患者,实施高强度聚焦超声手术,手术前后分别进行子宫DCE-MR和DWI检查,检测并记录血清Ca125的检验值,以对比手术前后消融灶、残留灶的表观弥散系数(ADC)、指数表观弥散系数(eADC)、最大增强斜率(MSI)、信号增强率(SER)值之间的差异;以血清Ca125的变化值为因变量,并结合手术前术后各参数相关值之间的不同自变量,进行相关性数据分析。结果DWI相关性参数ADC值以及DCE-MR相关性技术参数的SER、MSI值术后消融灶较术前明显降低,差异均有统计意义(P<0.01);残留灶与术前对比差异无统计意义(P>0.05);血清Ca125在高强度聚焦超声治疗后2个月变化水平与DWI、DCE-MR检查相关参数未表现出明显相关性。子宫腺肌症病灶大小及Ca125变化值与病灶消融体积均具有显著的正相关关系。结论DCE-MR和DWI扫描,在早期评估高强度聚焦超声治疗子宫腺肌病术后效果等方面,均具备了较大的临床实用价值。通过血清中Ca125测定值来早期评估对子宫腺肌病的严重程度和术后对消融效果的长期随访结果,可成为术后评价效果的重要辅助指标。Objective To investigate the value of dynamic enhanced magnetic resonance imaging(MRI)and diffusion-weighted imaging(DWI)parameters combined with Ca125 in evaluating the early curative effect of high-intensity focused ultrasound(HFOCUS)in the treatment of adenomyosis.Methods Thirty-two patients with adenomyosis underwent high-intensity focused ultrasound surgery,and the uterus was examined by DCE-MR and DWI at each time before operation.Serum Ca125 test values were detected and recorded to compare the differences of ADC,eADC,SER and MSI values between ablation foci and residual foci at each time period before high-intensity focused ultrasound surgery for adenomyosis,and whether there was statistical significance.The change value of serum Ca125 was taken as the dependent variable,and the correlation data was analyzed in combination with the different independent variables between the correlation values of parameters before and after surgery.Results The ADC values of DWI correlation parameters and SER and MSI values of DCE-MR correlation parameters were significantly lower than those before surgery,and the difference was statistically significant(P<0.01).The comparison between residual foci and preoperative foci was not statistically significant.There was no significant correlation between the change level of serum Ca1252 months after high-intensity focused ultrasound treatment and the related parameters of DWI and DCE-MR examination.The size of adenomyosis lesion and Ca125were positively correlated with ablation volume.Conclusion DCE-MR and DWI scans are of great clinical value in early evaluation of postoperative effects of high-intensity focused ultrasound in the treatment of adenomyosis.Ca125 in serum can be used to assess the severity of adenomyosis early and the long-term follow-up results of postoperative ablation,which can be an important auxiliary indicator for postoperative evaluation.

关 键 词：磁共振动态增强 弥散加权成像 高强度聚焦超声 子宫腺肌病 

分 类 号：R711.7[医药卫生—妇产科学]