超声造影评价高强度聚焦超声治疗子宫腺肌瘤的疗效

Evaluation of uterine adenomyoma treatment with high intensity focused ultrasound by contrast-enhanced ultrasound

目的探讨超声造影在高强度聚焦超声(HIFU)治疗子宫腺肌瘤疗效评价中的应用价值。方法选择痛经症状明显,经临床、超声检查诊断为子宫腺肌瘤,不愿接受手术治疗的已生育患者20例,在二维超声定位及实时监控下应用HIFU进行治疗。于HIFU治疗前1周、治疗后1、3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腺肌瘤大小、内部回声、血流变化及超声造影图像改变。结果 HIFU治疗后3个月及6个月,20个子宫腺肌瘤体积逐渐缩小,所有瘤体内部回声增强、彩色血流均消失。超声造影显示18个腺肌瘤内造影剂持续无灌注,2个瘤体内部呈网格状少许灌注。结论超声造影是HIFU治疗子宫腺肌瘤疗效评价的有效方法。

Objective To assess the efficacy of high intensity focused ultrasound （HIFU） for the treatment of uterine adenomyoma by contrast-enhanced ultrasound. Methods A total of 20 women with uterine adenomyoma who had children with HIFU treatment. In the process of treatment, real-time two-dimensional uhrasonography was used to guide the location of the focal field and monitor the ablating procedure. Conventional ultrasound, color Doppler ultrasound and contrast-enhanced ultrasound （CEUS） were performed 1 week before and 1,3 and 6 months after H1FU treatment to observe the changes of volume, echo, blood flow supply and contrast enhancement inside the uterine adenomyoma. Results After HIFU treatment,the volume of uterine adenomyoma decreased gradually,the inside echoes were increased, the blood signals decreased or disappeared in the treated regions. The contrast agent was nonperfusion in eighteen cases and hypoperfusion in two cases on CEUS,respectively. Conclusion CEUS is an effective method for evaluating the efficacy of HIFU treatment for uterine adenomyoma.