子宫肌瘤高强度聚焦超声治疗后的声像图评价

Evaluation of post high intensity focus ultrasound treatment for uterine fibroids by ultrasonography

目的分析高强度聚焦超声(HIFU)治疗子宫肌瘤结束后5分钟声像图判断疗效的价值。方法272例子宫肌瘤患者299个肌瘤,分析治疗结束后5分钟肌瘤声像特点并研究其与1年后复查结果之间的关系。结果依据治疗结束后5分钟声像图特点将肌瘤分为四类:1.团块状不均高回声160个,1年后123个体积缩小≥30%,35个介于0-30%之间,有效率约98.8%。2.落雪样斑块团46个,1年后31个体积缩小≥30%,13个介于0～30%之间,有效率95.7%。3.局部片状高回声57个,1年后32个体积缩小≥30%,12个介于0～30%之间,有效率77.2%。4.低-等回声36个,1年后6个体积缩小≥30%,2个介于0～30%之间,有效率22.2%。总有效率84.9%。其中团块状不均高回声(p<0.001)和落雪样斑块团(p<0.05)可作为结束治疗并预估治疗有效的声像变化。结论治疗结束后5分钟声像图是评估HIFU治疗子宫肌瘤效果的有效方法。

Objective To evaluate the value of ultrasonagraphy 5min after high intensity focus ultrasound（HIFU） therapy for uterin fibroid in the evaluation of treatment response. Methods Totally, 299 uterine fibroids in 272 patients were treated with HIFU and the ultrasonagrapjic feathurs 5 min later were analyzed with the clinical outcome one year after HIFU. Results The ultrasonaphic features of uterine fibroids 5 min after HIFU were classified as four types. The total efficiency was 84.9% one year later. Mass-like heterogeneous hyperechogenicity was detected in 160 fibroid with an effective rate of 98.8%（volume decrased more than 31）% in 123 fibroids and decrased 0-30% in 35 fibroid）. Snow-like mosaic echogenicity was detected in 46 fibroids with an effective rate of 93.7%（volume decrased more than 30% in 31 fibroids and decrased 0-30% in 13 fbroid）. Local hyperechogenicity was detected in 57 fibroids with an effective rate of 77.2%（volume decrased more than 30% in 32 fibroids and decrased 0-30% in 12 fibroid）. Hypo and hyperechogenicity was detected in 36 fibroids with an effective rate of 22.2%（volume decrased more than 30% in 6 fibroids and decrased 0-30% in 2 fibroids）. The mass-like heterogeneous hyperechogenicity and snow-like mosaic echogenicite were the characteristics of effective treatment. Conclusion The ultrasonagraphy 5 min after HIFU therapy for uterine fibroid is valuable in the evaluation of outcome after HIFU.