三维超声子宫肌瘤血管网评估HIFU消融疗效的应用价值

Application value of uterine leiomyomas vascular network in evaluating thetherapeutic efficacy of high intensity focused ultrasound ablation

目的:探讨三维超声子宫肌瘤血管网评估HIFU消融子宫肌瘤疗效的应用价值。方法:选取HIFU消融子宫肌瘤患者67例,在术前,术后当天、3、6和12月采用阴道三维高分辨力血流成像技术对靶肌瘤血供重建及分级,分析子宫肌瘤血管网评估治疗前、后子宫肌瘤血供与HIFU疗效的关系。结果:术前子宫肌瘤血管网的血供分级与增强MRI的强化等级对肌瘤内部血供评价的ICC为0.766(p=0.001),一致性较好。术后该血管网与超声造影评估HIFU疗效差异无统计学意义(p>0.05),术后当天及12月血供为0和1级的肌瘤缩小率明显高于3级,差异有统计学意义(P<0.05)。结论:三维超声子宫肌瘤血管网能显示子宫肌瘤血供,对HIFU疗效预估、术后随访有提示作用,具有一定的临床应用价值。

Objective:To evaluate the application value of three-dimensional ultrasound of uterine fibroids vascular network in evaluating the efficacy of high intensity focused ultrasound(HIFU)ablation of uterine fibroids.Methods:Sixty-seven patients with single uterine leiomyoma before and after HIFU treatment were selected,the vascular network of target leiomyoma was reconstructed and graded bythree-dimensional high definition flow.Enhanced MRI was used as standard.The correlation of different blood flow levels in the fibroids with uterine fibroid vascular network and the efficacy of HIFU were evaluated.Results:Before HIFU treatment,the vascular network of uterine fibroids showed different levels of blood flow signals in uterine fibroids.The correlation analysis of vascular network showed blood grades and MRI enhanced grades was 0.766(p=0.001),with close relationship.There was no statistical difference in evaluating the efficacy between uterine fibroid vascular network and CEUS after HIFU treatment(p>0.05).The ratio of the volume reduction at postoperative day and 12 months after HIFU in the third degree were lower than those in the zero and first degrees(p<0.05).Conclusions:Three-dimensional ultrasound uterine fibroids vascular network can display the internal blood flow levels of uterine fibroids intuitively,and the classification of uterine fibroids vascular network has a prompt effect on HIFU curative effect prediction and postoperative follow-up,provide some clinical reference values.