超声造影评估微波联合聚桂醇消融治疗子宫肌瘤疗效的临床研究  

Clinical Study on Contrast-Enhanced Ultrasound Evaluation of the Efficacy of Microwave Ablation Combined with Lauromacrogol in Treatment of Uterine Fibroids

作　　者：王娜[1] 郭学佳[1] 陈江红[1] 刘文聪[1] WANG Na;GUO Xuejia;CHEN Jianghong;LIU Wencong(Department of Ultrasound,The First Hospital of Hebei Medical University,Shijazhuang 050000,China)

机构地区：[1]河北省石家庄市河北医科大学第一医院超声科,河北省石家庄市050000

出　　处：《中国医学计算机成像杂志》2024年第6期749-754,共6页Chinese Computed Medical Imaging

摘　　要：目的:探究超声造影(CEUS)评估微波联合聚桂醇消融治疗子宫肌瘤患者的临床疗效。方法:回顾性分析本院2023年4月—2023年11月收治的315例长径>5 cm的子宫肌瘤患者临床资料,所有患者均接受微波消融联合聚桂醇治疗,观察手术情况,于治疗前及治疗后3个月进行CEUS与增强MRI检查,分析不同增强强度、增强形态、充盈缺损状态子宫肌瘤患者术后消融率差异,对比治疗前后子宫肌瘤CEUS时间强度曲线参数变化,探讨CEUS与增强MRI对消融率评估结果的一致性。结果:术前造影低增强患者术后消融率高于等增强患者,等增强高于高增强患者,有充盈缺损、不均匀增强患者术后消融率高于无充盈缺损、均匀增强患者(P<0.05)。CEUS时间强度曲线参数分析结果显示,相较于治疗前,子宫肌瘤微波消融联合聚桂醇治疗后达峰时间延长,峰值强度降低(P<0.05)。治疗后3个月,CEUS评估子宫肌瘤消融率包括80%~100%者222例,60%~80%者78例,40%~60%者15例,其中296例与增强MRI评估结果相符,符合率为93.97%;治疗后CEUS评估微波消融联合聚桂醇治疗长径>5 cm子宫肌瘤80%~100%、60%~80%、<60%消融率与增强MRI评估一致性的Kappa值分别为0.887、0.839、0.868。结论:CEUS和增强MRI检查在微波消融联合聚桂醇治疗长径>5 cm子宫肌瘤的术后疗效评估中,具有较高的一致性。Purpose:To evaluate clinical efficacy of microwave ablation combined with lauromacrogol in patients with uterine fibroids based on contrast-enhanced ultrasound(CEUS).Methods:The clinical data of 315 patients with uterine fibroid(diameter size>5 cm)in the hospital from April to November 2023 were retrospectively analyzed.All patients were treated with microwave ablation and lauromacrogol.The surgical situations were observed,and all patients underwent CEUS and enhanced MRI examinations before and at 3 months after treatment.The differences in postoperative ablation rate among patients with different enhancement intensity,enhancement morphology and filling defect state were analyzed.The changes in CEUS time-intensity curve parameters before and after treatment were compared.The consistency between CEUS and enhanced MRI for evaluating ablation rate was explored.Results:The postoperative ablation rate in patients with low enhancement in preoperative angiography was higher than that with moderate enhancement,and which in patients with equal enhancement was higher than that with high enhancement.The postoperative ablation rate in patients with filling defects and uneven enhancement was higher than that with filling non-defect and even enhancement(P<0.05).The results of CEUS time-intensity curve parameters analysis showed that time to peak was prolonged,and peak intensity was decreased after treatment(P<0.05).At 3 months after treatment,CEUS showed that there were 222 cases with ablation rate of 80%-100%,78 cases of 60%-80%and 15 cases of 40%-60%.Among them,there were 296 cases consistent with evaluation results of enhanced MRI,and the coincidence rate was 93.97%.After treatment,consistency Kappa values of CEUS and enhanced MRI for evaluating ablation rates of 80%-100%,60%-80%and<60%were 0.887,0.839 and 0.868,respectively.Conclusion:The consistency between CEUS and enhanced MRI is high in evaluating postoperative efficacy of microwave ablation combined with lauromacrogol in patients with uterine fibroid(diameter size>5

关 键 词：子宫肌瘤 微波消融术 聚桂醇 临床疗效 超声造影 

分 类 号：R737.33[医药卫生—肿瘤]