HIFU消融治疗不同MRI特征子宫肌瘤的效果

Effect of HIFU ablation of uterine fibroids with different MRI features

目的探讨HIFU消融治疗不同MRI特征子宫肌瘤的效果。方法回顾性分析经HIFU治疗的96例子宫肌瘤患者资料,比较HIFU治疗不同位置、类型、MRI信号特征和强化程度的子宫肌瘤的消融率和能效因子,并评估其安全性。结果平均肌瘤体积、消融率、能效因子分别为(107.14±70.85)cm3、(72.48±11.04)%和(7.45±3.05)J/mm3。不同位置、类型、信号特征和强化程度的子宫肌瘤之间,HIFU消融率和能效因子差异均有统计学意义(P均<0.05),对前壁、肌壁间、T2WI低信号、T1WI轻度强化肌瘤的消融率更高、能效因子更低(P均<0.05)。术中、术后未发现严重不良反应。结论 HIFU治疗子宫肌瘤相对安全,消融效果确切,其对前壁、肌壁间、T2WI低信号、T1WI轻度强化的子宫肌瘤的消融效果更好。

Objective To investigate the effect of HIFU ablation of uterine fibroids with different MRI characteristics.Methods Ninety-six patients with uterine fibroids treated with HIFU were retrospectively analyzed.The ablation rate and energy efficiency factor（EEF）of HIFU ablation on uterine fibroids with different locations,types,signal features on T2 WI and enhancement degree on contrast-enhanced T1 WI were compared,and the safety was evaluated.Results The average uterine fibroids volume,ablation rate and EEF was（107.14±70.85）cm3,（72.48±11.04）% and（7.45±3.05）J/mm3,respectively.There were significant differences in ablation rate and EEF of uterine fibroids among different locations,types,signal features on T2 WI and enhancement degree on contrast-enhanced T1 WI（all P〈0.05）.Uterine fibroids on anterior wall,intramural,T2 WI low signal and mild enhancement on contrast-enhanced T1 WI had higher ablation rate and lower EEF（all P〈0.05）.No serious adverse events were observed during and after the operation.Conclusion HIFU is relatively safe in the treatment of uterine fibroids with accurate ablation effect,and the ablation effect of uterine fibroids of the anterior wall,intramural,T2 WI low signal and mild enhancement on contrast-enhanced T1 WI is rather good.