1.5T MRI多参数成像评估HIFU治疗子宫肌瘤疗效及预后判断价值

Value of 1.5T MRI Multi-parameter Imaging in Evaluating the Curative Effect of HIFU and Determining Prognosis in Uterine Fibroid

目的探究1.5T MRI多参数成像评估高强度聚焦超声(HIFU)治疗子宫肌瘤的疗效以及对预后情况的判断价值。方法回顾性分析2016年1月~2021年12月期间,本院收治的子宫肌瘤患者共计102例。根据具体方案的不同将全部研究对象划分为常规HIFU组(n=47)以及1.5T MRI联合评估组(n=55),常规HIFU组接受HIFU法治疗子宫肌瘤,1.5T MRI联合评估组在治疗前接受了1.5T MRI多参数成像评估;比较两组研究对象接受HIFU治疗的主要参数(功率、持续时间、总能量、能效因子、消融率以及完全灭活率);全部研究对象接受治疗前后的T1WI、T2WI信号强度以及表观扩散系数(ADC值)。对上述研究对象进行定期的随访复查,在术后3个月比较两组研究对象的术后吸收率、累计消融率;在术后1年对进行复查,对比肌瘤复发率。结果两组研究对象的接受HIFU治疗后,1.5T MRI联合评估组的HIFU手术功率、总能量、效能因子均低于HIFU组;与此同时,消融率以及完全灭活率均高于HIFU组,差异均存在统计学意义(P<0.05)。随访结果显示,1.5T MRI联合评估组患者的累积消融率显著高于HIFU组(P<0.05);然而两组研究对象术后吸收率以及术后1年的肌瘤复发率差异无统计学意义(P>0.05);全部研究对象治疗前,正常子宫壁增强信号值无明显差异(P>0.05);接受治疗后,T1WI呈现升高趋势、T2WI、ADC呈现降低趋势,差异均存在统计学意义(P<0.05)。结论1.5T MRI多参数成像应用于HIFU治疗子宫肌瘤对于评估手术效果以及3个月后的累计消融率具有较高的应用价值,值得临床工作人员的借鉴应用。

Objective To explore the value of 1.5T MRI multi-parameter imaging in evaluating the curative effect of high-intensity focused ultrasound(HIFU)and determining prognosis in uterine fibroid.Methods A total of 102 patients with uterine fibroids admitted to the hospital were retrospectively analyzed between January 2016 and December 2021.According to different treatment methods,they were divided into HIFU group(n=47)and 1.5T MRI combined evaluation group(n=55).The HIFU group was treated with HIFU,while 1.5T MRI combined evaluation group was given 1.5T MRI multi-parameter imaging evaluation before treatment.The main HIFU parameter(power,duration,total energy,energy efficiency factor,ablation rate,complete inactivation rate).T1WI,T2WI signal intensity and apparent diffusion coefficient(ADC value)of all subjects before and after treatment.The above research objects were followed up regularly,and postoperative absorption rate and cumulative ablation rate in the two groups were compared at 3 months after surgery.All the objects were re-examined at 1 year after surgery to compare fibroid recurrence rate.Results After HIFU,surgical power,total energy and energy efficiency factor in 1.5T MRI combined evaluation group were lower than those in HIFU group,while ablation rate and complete inactivation rate were higher than those in HIFU group(P<0.05).The follow-up results showed that cumulative ablation rate in 1.5T MRI combined evaluation group was significantly higher than that in HIFU group(P<0.05).However,there was no significant difference in 3 month postoperative absorption rate or fibroid recurrence rate at 1 year after surgery between the two groups(P>0.05).Before treatment,there was no significant difference in the enhanced signal values of normal uterine wall in all subjects(P>0.05).After treatment,T1WI showed an increasing trend,T2WI and ADC showed a decreasing trend,and the differences were statistically significant(P<0.05).Conclusion The application value of 1.5T MRI multi-parameter imaging is high in evaluating curative effect of HIFU and cumulative ablation rate at 3 months after surgery in uterine fibroid,which is worthy of reference for clinical staffs.