不同b值弥散加权成像评价子宫肌瘤高能聚焦超声疗效的比较

发布时间：2018-05-02 11:08

本文选题：磁共振成像 + 扩散成像　；参考：《广东医学》2017年01期

【摘要】：目的对比分析大小b值的弥散加权成像(DWI)评价子宫肌瘤高能聚焦超声(HIFU)术后消融疗效。方法连续收集25例(34个子宫肌瘤)患者进行HIFU治疗,术前、术后24 h内行常规MR、CE-MRI及b值分别取150、1 000 s/mm~2的单指数DWI检查。观察术前、术后两组b值消融灶的DWI信号改变,比较各b值术前、术后消融灶和残留未消融灶的表观扩散系数(ADC)值变化。分析各b值ADC图消融灶与CE-MRI无血流灌注区域(NPV)的一致性。结果 b值为150 s/mm~2时,术后消融灶ADC值是(1.48±0.27)×10~(-3)mm~2/s,术前ADC值是(2.06±0.21)×10~(-3)mm~2/s及残留未消融灶ADC值是(1.98±0.23)×10~(-3)mm~2/s,术后ADC值低于术前及残留未消融灶(P0.05);消融灶与残留未消融灶两者间的ADC值ROC曲线显示,当界值取ADC值≤1.53×10~(-3)mm~2/s时,曲线下面积为0.912,敏感度为83.2%,特异度为85.6%。b值为1 000 s/mm~2时,消融灶术前、术后ADC值以及残留未消融灶ADC值差异无统计学意义(P0.05)。b值为150 s/mm~2的ADC图消融灶与NPV有较高一致性(ICC值=0.78,P0.05),优于b值为1 000 s/mm~2DWI图及其ADC图。结论小b值(150 s/mm~2)的ADC值量化改变可以间接反映子宫肌瘤HIFU术后的微循环灌注变化,其ADC图显示的消融灶与CEMRI的NPV相对应,有助于评价消融疗效。
[Abstract]:Objective to compare the effect of B value with diffusion weighted imaging (DWI) to evaluate the curative effect of uterine myoma after high energy focused ultrasound (HIFU). Methods 25 patients (34 hysteromyoma) were continuously collected for HIFU treatment. Preoperative, 24 h after operation, routine MR, CE-MRI and b value of 150,1 000 s/mm~2 respectively, respectively. Two groups of B before and after operation were observed. The changes in the DWI signal of the ablation range were compared. The apparent diffusion coefficient (ADC) values of the ablation foci and the remaining unablation foci were compared before the b value. The consistency between the ADC ablation range and the CE-MRI free perfusion region (NPV) was analyzed. The results showed that the b value was 150 s/mm~2, and the ADC value of the ablation range was (1.48 + 0.27) * 10~ (-3), and the preoperative value was (2.06). The ADC value of + 0.21) 10~ (-3) mm~2/s and residual non ablation range was (1.98 + 0.23) x 10~ (-3) mm~2/s, and the ADC value after operation was lower than that before and in the residual non ablation range (P0.05), and the ADC value ROC curve between the ablation focus and the remaining non ablation range showed that when the boundary value was less than 1.53, the area under the curve was 0.912, the sensitivity was 83.2%, and the specificity was 85.6. When the value of%.b was 1000 s/mm~2, there was no significant difference in ADC value and ADC value of residual unablation range before ablation. The ADC map ablation stove with.B value of 150 s/mm~2 had higher consistency with NPV (ICC value =0.78, P0.05). The changes of microcirculation perfusion after hysteromyoma HIFU showed that the ablation foci of ADC showed corresponding to the NPV of CEMRI, which was helpful to evaluate the effect of ablation.

【作者单位】：暨南大学附属江门中医院江门市五邑中医院医学影像科;暨南大学附属江门中医院江门市五邑中医院肿瘤介入科;暨南大学附属第一医院影像中心;
【基金】：广东省江门市科技计划项目(编号:江科[2015]75号-19)
【分类号】：R737.33

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