超声造影评价高强度聚焦超声消融治疗子宫肌瘤疗效的初步应用

Assessment of treatment response of uterine leiomyomas after high intensity focused ultrasound ablation with contrast-enhanced ultrasound: a preliminary study

目的探讨超声造影评价高强度聚焦超声治疗子宫肌瘤疗效的有效性。方法11例子宫肌瘤患者(12个病灶)分别在高强度聚焦超声治疗前3天、治疗后1个月、3个月及6个月采用常规二维超声、彩色多普勒超声及超声造影观察肌瘤大小、血流及造影改变。结果子宫肌瘤治疗后体积缩小明显,治疗后1个月、3个月及6个月体积缩小率分别为39．21±19．68%、55．58±25．69％、74．15±29．66％(P<0．05);肌瘤内部及周边的血流消失或基本消失:时间-强度曲线显示正常子宫肌层治疗前后造影剂灌注未见明显改变, 11个病灶治疗后呈持续造影剂无灌注或低灌注状态,余1个病灶边缘动脉期有小片状造影剂灌注。所有患者治疗后临床症状改善明显,少有并发症发生。结论超声造影是评价高强度聚焦超声治疗子宫肌瘤疗效的一种有效、简便的方法。

Objective To assess the efficacy of high intensity focused ultrasound （HIFU） for the ablation treatment of uterine leiomy-omas with contrast-enhanced ultrasound. Methods Eleven cases with 12 uterine leiomyomas underwent HIFU ablation treatment. The changes of volume, blood flow supply and contrast enhancement of leiomyomas were observed at 3 days before and 1,3 and 6 months after treatment with general ultrasound,color Doppler ultrasound and contrast-enhanced ultrasound, respectively. Results The volume of 12 leiomyomas had a mean reduction of 39.21±19.68%,55.58±25.69 %,74.15±29.66% at 1,3 and 6 months after treatment, respectively. Color flow signals in leiomyomas almost disappeared.The enhancement of normal uterine muscular layers had no difference in the time-intensity curves before and after treatment, while the leiomyomas after treatment was in a state of ischemic, except one leiomyoma had yet a small patchy enhancement in arterial phase. Clinical symptoms were alleviated notablely. There were rare complications observed in 11 cases. Conclusions Contrast-en- hanced ultrasound is an effective and easy method in the evaluation of high intensity focused ultrasound for the ablation treatment of uterine leiomyomas.