超声造影对化瘤方治疗子宫肌瘤的疗效评价

Treatment evaluation of hysteromyoma with a traditional Chinese Hualiu prescription by contrast-enhanced ultrasound

目的探讨超声造影评估子宫肌瘤中药治疗疗效。方法选用造影剂声诺维(SonoVue),采用对比脉冲序列成像(CPS)超声造影技术,对32例子宫肌瘤患者在化瘤方治疗前后进行超声造影检查,观察子宫肌瘤的造影模式并用软件进行时间强度曲线分析。结果32例子宫肌瘤的造影灌注模式分为三型:①周边向心型19例②同步型2例③内部扩散型11例,中药治疗后6个月子宫肌瘤的灌注模式未发生改变;24例中药治疗后肌瘤体积缩小的患者到达时间(AT)无明显改变,平均渡越时间(mTT)、达峰时间(TTP)延长,峰值强度(IMAX)、曲线下面积(AUC)及总灌注量(V)均下降;8例肌瘤体积增大的患者中有4例患者的时间强度曲线参数符合肌瘤体积缩小的参数改变。结论超声造影时间强度曲线分析,能更准确地评价子宫肌瘤的治疗效果。

Objective To investigate the clinical value of contrast-enhaced ultrasound （CEUS） in the treatment ofhysteromyoma with a Chinese Hualiu prescription. Methods Thirty-two patients with hysteromyoma were treated with a Chinese medicine of Hualiu prescription and examined with CEUS before and after the treatment by using SonoVue and Contrast Pulsed Sequence （CPS） technique. The enhancement patterns were observed and time-intensity curve were analyzed with software. Results The enhancement patterns of hysterornyoma on CEUS were centripetal type （19 cases）, synchronous type （2 cases） and internal diffusion type （11 cases） before treatment. The enhancement patterns were similar on CEUS six months after treatment with Chinese medicine. In 24 cases, the volume of hysteromyoma decreased as the arrival time didn＇t change, mean transit time and time to peak prolonged, and the peak intensity, area under curve and total peffusion decreased as well. In 8 cases, the volume of hysteromyoma increased and the parameters changed similar with those decreased hysteromyoma in 4 cases. Conclusion Analysis of time intensity curve of CEUS is helpful in the evaluation of treatment response ofhysteromyoma accurately.