MR T2WI信号特征预测HIFU消融治疗子宫腺肌病疗效

Signal characteristics of MR T2WI in prediction of HIFU treatment outcome for adenomyosis

目的探讨MR T2WI信号特征对HIFU消融治疗子宫腺肌病疗效的预测作用。方法 502例接受HIFU消融治疗的子宫腺肌病患者,根据术前MR T2WI信号特征分为Ⅰ组(以低信号为主,可有少量等信号)和Ⅱ组(以等信号为主,可有少量低信号);每组进一步分为A(无稍高和极高信号)、B(有稍高信号)、C(有极高或极高合并稍高信号)亚组。分析子宫腺肌病T2WI信号特征与超声消融效果和参数的关系。结果Ⅰ组与Ⅱ组病灶体积消融率(NPVR)差异无统计学意义(t=-0.504,P=0.612)。两组中A亚组NPVR均高于B亚组及C亚组(Ⅰ组:LSD-t=2.608、3.677,P=0.009、<0.001;Ⅱ组:LSD-t=3.255、3.778,P=0.001、<0.001),B亚组与C亚组NPVR差异无统计学意义(Ⅰ组:LSD-t=-0.852,P=0.395;Ⅱ组:LSD-t=0.278,P=0.781)。Ⅰ组与Ⅱ组辐照时间、总消融剂量和能效因子(EEF)差异均无统计学意义(辐照时间:t=-1.716,P=0.087;总消融剂量:t=-1.676,P=0.094;EEF:Z=0.044,P=0.965);两组A亚组辐照时间、总消融剂量和EEF均低于B亚组及C亚组(P均<0.05),B亚组与C亚组辐照时间、总消融剂量和EEF差异均无统计学意义(P均>0.05)。结论 MR T2WI信号特征对HIFU消融治疗子宫腺肌病难易程度和消融效果具有重要预测作用。

Objective To investigate the effect of signal characteristics of MR T2 WI for predicting HIFU treatment outcome for adenomyosis.Methods According to signal characteristics of MR T2 WI before HIFU treatment,502 adenomyosis patients were divided into groupⅠ（lesions with most hypointense and/or little isointense）and group Ⅱ（lesions with most isointense and/or little hypointense）.Then patients in each group were further subdivided into subgroup A（without slightly and extremely hyperintense foci in the lesions）,subgroup B（with slightly hyperintense foci in the lesions）or subgroup C（with extremely and/or slightly hyperintense foci in the lesions）.The correlation of signal characteristics of MR T2 WI for adenomyosis on HIFU ablation results and parameters were analyzed.Results There was no statistical difference of non-perfused volume ratio（NPVR）between groupⅠand groupⅡ（t=-0.504,P=0.612）.In both group Ⅰ and group Ⅱ,NPVR of subgroup A was higher than that of subgroup B and subgroup C,respectively（group Ⅰ：LSD-t=2.608,3.677,P=0.009,〈0.001;group Ⅱ：LSD-t=3.255,3.778,P=0.001,〈0.001）.There was no statistical difference of NPVR between subgroup B and subgroup C（groupⅠ：LSD-t=-0.852,P=0.395;groupⅡ：LSD-t=0.278,P=0.781）.There was no statistical difference of sonication time,total ablation energy and energy efficiency factor（EEF）between group Ⅰ and group Ⅱ,respectively（sonication time：t=-1.716,P=0.087;total ablation energy：t=-1.676,P=0.094;EEF：Z=0.044,P=0.965）.In both group Ⅰ and group Ⅱ,sonication time,total ablation energy and EEF of subgroup A were lower than those of subgroup B and subgroup C（all P〈 0.05）,while no statistical difference was found between subgroup B and subgroup C（all P〉 0.05）.Conclusion Signal characteristics of adenomyosis on MR T2 WI can be used as predictors of HIFU treatment outcome for adenomyosis.