DWI在HIFU消融治疗子宫肌瘤术后评价中的应用

发布时间：2018-05-16 21:42

本文选题：子宫 + 平滑肌瘤　；参考：《中国介入影像与治疗学》2015年10期

【摘要】：目的探讨DWI在高强度聚焦超声(HIFU)消融治疗子宫肌瘤术后评价中的应用价值。方法对270例患者(共270个子宫肌瘤)行HIFU消融治疗,于术前及术后分别行增强磁共振成像(CE-MRI)及DWI检查,其中A组98例术后MRI于消融当日(术后6h内)完成,B组172例术后MRI于消融后1~2天(24~48h)完成。分析病灶ADC值变化,观察DWI特征。并测量DWI信号改变区体积及CE-MRI无灌注区体积(NPV),分析二者间的相关性。结果 DWI示HIFU消融后子宫肌瘤呈靶环样改变。两组患者消融前子宫肌瘤ADC值差异无统计学意义(t=-0.322,P=0.748),消融后ADC值差异有统计学意义(t=8.874,P0.001)。A组术后ADC值较术前减低(t=3.500,P=0.001),B组术后ADC值较术前增高(t=-16.842,P0.001)。HIFU消融后DWI信号改变区中位体积为50.78cm3(四分位间距30.03~89.60cm3),CE-MRI的NPV为52.65cm3(四分位间距30.03~89.60cm3),差异无统计学意义(z=-1.357,P=0.175),且二者呈正相关关系(r=0.989,P0.001)。结论 DWI可用于HIFU消融治疗子宫肌瘤术后短期疗效的评价。
[Abstract]:Objective to evaluate the value of DWI in the treatment of uterine leiomyoma by high intensity focused ultrasound (HIFU) ablation. Methods 270 patients (270 uterine leiomyomas) were treated with HIFU ablation. CE-MRI and DWI were performed before and after operation. In group A, 98 cases of postoperative MRI were completed on the day of ablation (within 6 hours after operation). In group B, 172 cases of postoperative MRI were completed on 1 day and 2 days after ablation. The changes of ADC were analyzed and the characteristics of DWI were observed. The volume of the change area of DWI signal and the volume of no perfusion area of CE-MRI were measured and the correlation between them was analyzed. Results DWI showed that uterine leiomyoma showed target loop changes after HIFU ablation. There was no significant difference in ADC value of uterine leiomyoma between the two groups before ablation. There was no significant difference in ADC value between two groups before and after ablation. The ADC value of group A was significantly higher than that of group A after ablation. The postoperative ADC value of group A was significantly lower than that of group B after ablation, and the ADC value of group B was higher than that of group B after ablation. The NPV of CE-MRI with product 50.78 cm ~ 3 (quartile spacing 30.03 ~ 89.60 cm _ 3) was 52.65 cm ~ 3 (quartile spacing 30.03 ~ 89.60 cm ~ (3). There was no significant difference between them. There was no significant difference between them, and there was a positive correlation between them (r _ (0.989) P _ (0.001). Conclusion DWI can be used to evaluate the short-term effect of HIFU ablation for uterine leiomyoma.
【作者单位】：重庆医科大学生物医学工程学院省部共建超声医学工程国家重点实验室超声医学工程重庆市重点实验室;
【基金】：国家重点基础研究发展计划(973计划)项目(2011CB707900) 重庆市自然科学基金(cstc2012jjA10083) 2011年高等学校博士学科点专向科研基金联合资助课题(20115503110008)
【分类号】：R737.33;R445.2

【参考文献】