MRI在高强度聚焦超声治疗子宫腺肌症近期疗效评估中的价值

Value of MRI in evaluation of therapeutic efficacy of high intensity focused ultrasound in treatment of uterine adenomyosis

目的探讨MRI在高强度聚焦超声治疗子宫腺肌症近期疗效评估中的价值。方法对本院35例经临床诊断明确的子宫腺肌症患者行高强度聚焦超声治疗，患者于术前、术后1天、术后3个月、术后6个月行常规MRI扫描、动态增强扫描，观察治疗前后信号变化、无灌注区体积，计算消融率，观察病灶缩小率及临床症状改善情况，对其疗效进行评估。结果35例患者术后1天平均消融率为（70．2±20．5）％。20例（57．1％）患者治疗后月经延长及疼痛症状明显好转或消失，腺肌症病灶体积缩小〉50．0％；10例（28．6％）患者治疗后相关临床症状有所好转，病灶体积缩小〈50．0％；5例（14．3％）患者相关临床症状无好转。结论高强度聚焦超声治疗子宫腺肌症具有较高的安全性和有效性，MRI是高强度聚焦超声治疗子宫腺肌症近期疗效评估的有效手段。

Objective To explore the value of MRI in the evaluation of the therapeutic efficacy of high intensity focused ultrasound （HIFU） in the treatment of uterine adenomyosis. Methods 35 patients with uterine adenomyosis were treated by HIFU. Before and 1 day and 3 and 6 months after the operation, all the patients were routinely and contrast-enhancedly scanned by MRI. The changes of signal, volume of non-perfusion area, ablation rate, lesion reduction rate, and improvement of clinical symptoms were observed. The treatment effect was evaluated. Results The average ablation rate was （70.2±20.5）% one day after the operation. 20 patients （57.1%） with dysmenorrhea and menorrhagia alleviated obviously; the lesion reduction volume was over 50.0%. 10 patients （28.6%） with symptoms was improved; the lesion reduction volume was below 50.0%. 5 patients （14.3%） with symptoms were the same as before. Conclusions High intensity focused ultrasound for uterine adenomyosis is effective and safe. MRI in the evaluation of therapeutic efficacy of high intensity focused ultrasound in the treatment of uterine adenomyosis is effective.