高强度聚焦超声治疗子宫肌瘤效果的超声造影与MRI相关因素分析

Contrast-enhanced ultrasound and MRI factors influencing therapeutic effects of high intensity focused ultrasound in treatment of hysteromyoma

目的:探讨影响高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗子宫肌瘤效果的超声造影(contrast-enhanced ultrasound,CEUS)与MRI相关参数。方法:对49例子宫肌瘤患者在HIFU治疗前、治疗后进行CEUS及MRI检查,对患者的临床资料、检查结果及疗效进行分析。术前分析患者年龄,靶皮距,肌瘤位置、类型、体积,CEUS达峰时间(time to peak,TTP)、达峰强度(peak intensity,PI)、增强形态,MRI T2WI信号强度及增强程度,术后评估病灶消融率。结果:HIFU治疗的49例子宫肌瘤中,35例消融率≥70%,14例<70%。Logistic回归分析发现,TTP、PI、T2WI信号强度、MRI增强程度与HIFU治疗子宫肌瘤疗效相关(P<0.05)。结论:子宫肌瘤的CEUS及MRI相关参数TTP、PI、MRI T2WI信号强度及MRI增强程度是HIFU治疗消融率的独立影响因素,可用于预测HIFU治疗子宫肌瘤的疗效。

Objective To explore the contrast-enhanced ultrasound （CEUS） and MRI factors influencingthe therapeutic effects of high intensify focused ultrasound （HIFU） in the treatment of hysteromyoma. Methods：Forty-nine patients with hysteromyoma were examined by CEUS and MRI before and after HIFU treatment. Thedata of patient’s age, target-skin distance, hysteromyoma location, type, volume, time to peak （TTP）, peak intensity,enhanced morphology of CEUS, signal intensity of preexisting T2-weighted and enhancement degree of MR imageswere analyzed respectively. After HIFU treatment, non-perfused volume （NPV） was observed. Results： After HIFUtreatment, 35 cases had NPV ratio ≥70%, and 14 cases had NPV ratio 〈70%. Logistic analysis showed that TTP,peak intensity, signal intensity of preexisting T2-weighted and enhancement degree of MR images were associatedwith HIFU efficiency （P〈0.05）. Conclusion： TTP, peak intensity, signal intensity of preexisting T2-weighted andenhancement degree of MR images could affect HIFU efficiency in the treatment of hysteromyoma, and may be used topredict the therapeutic effects of HIFU.