高强度聚焦超声消融滋养动脉治疗子宫肌瘤的临床价值

The clinical value of the leiomyoma treatment by ablating the nourishing artery with high intensity focused ultrasound

目的：探讨高强度聚焦超声消融滋养动脉治疗子宫肌瘤的可行性及有效性。方法：47例直径4~10cm肌壁间肌瘤,高强度聚焦超声治疗前通过彩色多普勒及超声造影确定肌瘤滋养动脉的蒂,对该区域进行消融,观察治疗前后肌瘤内部彩色多普勒及超声造影等影像学变化、随访临床症状及并发症。结果：治疗后肌瘤体积有不同程度的缩小,瘤体假包膜环状血流信号消失,肌瘤内部处于持续无灌注状态,部分患者临床症状消失或明显改善。结论：HIFU消融滋养动脉治疗子宫肌瘤能够缩短治疗时间,减少并发症,是一种微创和有效的方法。

Objective： To study the clinical value of the leiomyoma treatment by ablating the nourishing artery with high intensity focused ultrasound.Methods： Before HIFU treatment,the pedicle origins in the false capsule of the leiomyoma are determined by CDFI and contrast-enhanced ultrasound for 47 cases of leiomyomas with 4~10cm diameter.HIFU treatment is carried out in this focal region.The changes of the presentation images of CDFI and contrast-enhanced ultrasound before and after HIFU treatment are detected to evaluate the effectiveness of HIFU treatment.The changes of the clinical symptoms and complications are followed up.Results： The volume of the leiomyoma decreases gradually after HIFU treatment.A annular blood flow signals of pseudocapsule in tumor body disappears with the diminution and necrosis of the tumors at different extents,and there is no contrast agent perfusion into the leiomyoma.Some patients＇clinica1 symptom disappears or is improved after treatment.Conclusion： The therapy by ablating the leiomyoma nourishing artery with HIFU could reduce treatment time and complications.It is a minimal-invasive,safe and effective way for leiomyoma treatment.