MRI预测HIFU治疗黏膜下肌瘤的可行性研究  

Feasibility Study on MRI Prediction of HIFU Therapy for Submucosal Fibroid

作　　者：徐嘉璐[1] 程杰军 孙明华[1] 朱家樑[1] XU Jialu;CHENG Jiejun;SUN Minghua(Department of Radiology,Shanghai First Maternity and Infant Hospital Affliated with Tongji University,Shanghai 201204,P.R.China)

机构地区：[1]同济大学附属上海市第一妇婴保健院放射科,上海201204

出　　处：《临床放射学杂志》2022年第10期1930-1934,共5页Journal of Clinical Radiology

基　　金：同济大学附属第一妇婴保健院科研基金项目(编号:2022RC04);上海市第一妇婴保健院浦东新区妇产科医联体合作项目。

摘　　要：目的 磁共振检查评估高强度聚焦超声(HIFU)消融子宫黏膜下肌瘤的疗效及影响因素。方法 回顾性分析72例接受HIFU消融治疗女性患者的72个黏膜下肌瘤临床及影像资料。所有病例在HIFU消融后即刻行MRI增强扫描,记录无灌注区体积占比(NPVR),并在治疗后3个月进行随访,记录NPVR及肌瘤体积缩小率。结果 72例HIFU治疗后的黏膜下肌瘤,其中1型30例,2型24例,2~5型18例,即刻MR扫描NPVR≥80%为88.9%(64/72),HIFU消融后3个月NPVR≥80%为61.1%(44/72)。HIFU后3个月子宫肌瘤体积缩小率>50%为30.6%(22/72),子宫肌瘤体积缩小率> 20%为76.4%(55/72)。HIFU后3个月肌瘤缩小率与T_(2)WI高信号,肌瘤最大径,促性腺激素释放激素类似物(GnRHa)预处理相关(P<0.05)。结论 肌瘤的T_(2)WI信号特点和GnRHa预处理对预测子宫黏膜下肌瘤消融效果具有重要价值。Objective MRI examination to evaluate the efficacy and influencing factors of high-intensity focused ultrasound(HIFU)ablation of uterine submucosal fibroids of uterus.Methods A retrospective analysis of 72 submucosal fibroids in 72 women HIFU ablation was performed.All patients underwent MRI enhancement immediately after HIFU ablation and NPVR was recorded.NPVR and the rate of fibroid volume reduction were followed up at 3 months Results 72 cases of submucosal fibroids treated with HIFU included 30 cases of type 1,24 cases of type 2,and 18 cases of type 2-5.All submucosal fibroids immediate MR scan NPVR≥80% was 88.9%(64/72),and 3 months after HIFU ablation NPVR≥80% was 61.1%(44/72).The follow-up results showed that 3 months after HIFU treatment,the volume reduction rate of uterine fibroids>50% was 30.6%(22/72),and the volume reduction rate of uterine fibroids>20% was 76.4%(55/72).High signal value on T_(2)WI,maximum diameter of the fibroid,and GnRHa pretreatment were important factors affecting the fibroid reduction rate 3 months after HIFU.Conclusion FIGO classification and size of fibroids,characteristics of T_(2)WI magnetic resonance signal and GnRHa pretreatment are of great value in predicting the ablation effect of submucosal fibroids.

关 键 词：子宫肌瘤 高强度聚焦超声 磁共振成像 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]