1.5T MRI对高强度聚焦超声治疗子宫肌瘤的疗效评价

Curative effect evaluation of 1.5T MRI to hysteromyoma treated by high-intensity focused ultrasound (HIFU)

目的:研究子宫肌瘤经高强度聚焦超声(HIFU)治疗前后的MRI信号变化,对其治疗效果进行评估,为临床治疗提供参考依据。方法:应用GE SignaHDe 1.5T超导型磁共振对经HIFU治疗前及术后一周内的83例子宫肌瘤患者(共117个肌瘤)行平扫和增强扫描,观察病灶是否出现凝固性坏死及其血供变化,从而对治疗效果进行评价。病灶内部出现凝固性坏死、血供明显减少者表明治疗效果佳;病灶内部未出现凝固性坏死,血供改变不明显者,治疗效果欠佳。结果:对2012年3月至2012年11月期间经HIFU刀治疗的83例子宫肌瘤患者(共117个肌瘤)进行回顾性分析。83例患者术前及术后均行MR平扫、增强扫描。术后病灶信号发生明显改变者106个,术前T1WI低信号,T2WI低信号,术后T1WI稍高信号或等信号,T2WI低信号或稍高信号,即表现为凝固性坏死,LAVA动态增强扫描显示病灶部位血供明显减少。11个子宫肌瘤术前、术后MRI信号改变不明显,LAVA动态增强扫描显示病灶部位血供未见明显改变。结论:通过MRI观察子宫肌瘤HIFU刀治疗前后的信号和血供改变,评价其治疗效果,是目前评价HIFU刀治疗子宫肌瘤疗效的最佳手段,值得临床推广和应用。

Objective： To study the MRI signal changes of hysteromyoma before and after treated by high-intensity focused ultrasound （HIFU）, evaluate the effects of HIFU treatment and providing the reference for clinical therapy. Methods： MR scan and enhanced-scan were performed by GE SignaHDe 1.5T MR system on 83 patients with hysteromyoma （a total of 117 myomatas） before and after HIFU treatment within one week. Through the observation of whether there were coagulation necrosis and blood supply diminution to evaluate the effects of HIFU treatment. The appearance of coagulation necrosis and blood supply diminution meant a remarkable therapeutic effect, and vice versa. Results： By analyzing the MR images of 83 patients with hysteromyoma （a total of 117 myomata） treated by HIFU from March 2012 and November 2012, we found that 106 myomata’s MRI signals clearly changed, from low signal to slightly high or equal signal on T1WI, from low signal to low or slight high signal on T2WI, which meantcoagulation necrosis and blood supply diminution. Besides, the rest 11 myomata’s MRI signal showed no changes before and after HIFU treatment on both coagulation necrosis and blood supply diminution. Conclusion： MRI is the most effective methods on evaluating the effects of HIFU treatments.