MR扩散成像在子宫肌瘤HIFU术后早期的疗效评价

Evaluation of Early Effect of MR Diffusion Imaging in Hysteromyoma After HIFU

目的探讨MR扩散成像在子宫肌瘤HIFU术后早期疗效评价之中的价值。方法选择2018年1月—2019年1月在医院治疗的20例子宫肌瘤患者共28个肌瘤当做研究对象,并对所有患者采用一次性HIFU刀进行治疗,分别在术前、术后30 min以及术后24 h通过DWI成像以及常规磁共振成像,对肌瘤手术前后在DWI、常规磁共振成像上的信号和ADC值出现的变化情况进行分析。结果术后24个肌瘤通过增强扫描为不存在灌注区,在DWI序列上均存在信号增高,且程度不一;肌瘤消融区术后30 min的平均ADC值比术前平均ADC值更低,且与未消融区平均ADC值相比更低(P<0.05);经术后24 h对患者复查,消融区平均ADC值出现回升,术前、术后30 min、术后24 h以及未消融区的平均ADC值的差异有统计学意义,P<0.05;消融区术后30 min的DWI高信号集中分布在外周,在中央部位的信号较低,且呈现出环形高信号的改变,外周部的ADC值与中央部相比较低。结论DWI以及ADC值均是对子宫肌瘤HIFU术后疗效评价的有效方法。

Objective To evaluate the value of MR diffusion imaging in the early evaluation of HIFU after hysteromyoma Methods A total of 28 myomas of 20 patients treated in our hospital from January 2018 to January 2019 were selected as study subjects,and all patients were treated with a one-time HIFU knife to analyze the changes in the signal and ADC values on DWI,conventional magnetic resonance imaging before and after operation by DWI imaging for 30 min and 24 h after operation,respectively.Results The results showed that there was no perfusion area in the 24 myomas after operation,and the signal increased on DWI sequence with different degrees;the average ADC value of the ablation area was lower than that of the preoperative average ADC value,and was lower than the average ADC value of the non ablation area(P<0.05);the average ADC value of the ablation area increased after 24 h after the operation,and the average ADC value of the ablation area increased before operation,30 min after operation and 24 h after operation The difference of average ADC value between ablation area and non ablation area was statistically significant,P<0.05;the high signal intensity of DWI in 30 min after ablation was concentrated in the peripheral region,and the signal in the central part was lower,and showed a ring high signal change,and the ADC value of the peripheral part was lower than that of the central part.Conclusion DWI and ADC are effective methods to evaluate the effect of HIFU after operation.