低场强MRI对超声引导下经皮穿刺微波消融子宫肌瘤疗效的评价

发布时间：2018-07-26 17:23

【摘要】：目的：探讨低场强MRI对超声引导下经皮穿刺微波消融（MWA）子宫肌瘤疗效的评价。方法： 128例154个子宫肌瘤行超声引导下经皮穿刺微波消融。分别于治疗前1天，治疗后3天行磁共振（MRI）增强扫描，总结子宫肌瘤微波治疗前后的MRI特征，分析治疗前后MRI信号强度变化。结果：微波治疗后与治疗前比较，治疗前病灶内强化程度明显减轻，病灶大小无明显变化。微波消融治疗后的子宫肌瘤MRI特征性信号改变与机载的超声造影显像变化比较，无统计学显著性差异（P0.05）。MRI T2WI信号为低、等、高、混染信号的子宫肌瘤体积消融率分别为(86.03±11.44)%、(70.43±14.54)%、(64.33±17.51)%、(71.54±19.32)%。MRI T2WI呈高信号的子宫肌瘤体积消融率明显低于低信号的肌瘤，，有统计学显著性差异(P0.05)。MRI T1WI增强信号呈低信号、等信号、高信号的子宫肌瘤体积消融率分别为(83.30±16.72)%、(75.83±17.21)%。、(67.32±15.63)%。MRI增强扫描T1信号强度越高，微波消融体积消融率越低，不同血供的肌瘤消融疗效有统计学显著性差异(P0.05)。术中、术后并发症中出现下腹部疼痛103例，占66.89%；骶尾部、臀部疼痛82例，占53.25%；术区皮肤损伤3例，占1.95%；阴道淡血性分泌物24例，占15.58%；下肢疼痛、麻木8例，占5.20%；低热53例，占34.42%。结论： MRI平扫及增强扫描对超声引导下经皮穿刺微波消融子宫肌瘤具有十分重要的评估价值，MRI平扫及增强扫描病变信号强度变化对微波治疗效果具有重要参考价值。
[Abstract]:Objective: to evaluate the effect of low field MRI on ultrasound guided percutaneous microwave ablation of (MWA) uterine leiomyoma. Methods: ultrasound guided percutaneous microwave ablation of 154 uterine leiomyomas was performed in 128 cases. Mr (MRI) enhanced scanning was performed 1 day before and 3 days after treatment to summarize the characteristics of MRI before and after microwave treatment of uterine leiomyoma and to analyze the changes of MRI signal intensity before and after treatment. Results: after microwave treatment, the enhancement degree of the lesion was obviously reduced and the size of the lesion was not changed. There was no significant difference between the changes of MRI characteristic signal of uterine leiomyoma after microwave ablation and that of airborne ultrasound imaging (P0.05). The ablation rate of uterine myoma volume with mixed signal was (86.03 卤11.44), (70.43 卤14.54), (64.33 卤17.51), (71.54 卤19.32). The ablation rate of myoma volume with high signal intensity was significantly lower than that of hysteromyoma with low signal intensity (P0.05). The volume ablation rate of hysteromyoma with high signal intensity was (83.30 卤16.72), (75.83 卤17.21) and (67.32 卤15.63), respectively. Intraoperative complications included lower abdominal pain in 103 cases (66.89%), sacrococcygeal and hip pain in 82 cases (53.2535), skin injury in 3 cases (1.95%), vaginal discharge in 24 cases (15.58), lower limb pain and numbness in 8 cases (5.20%). There were 53 cases of low fever, accounting for 34.42%. Conclusion: MRI plain scan and enhanced scan are very important for ultrasound guided percutaneous microwave ablation of uterine leiomyoma.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33;R445.2

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