IVIM-DWI和DCE-MRI评估高强度聚焦超声刀治疗子宫肌瘤的疗效

目的分析体素内不相干运动扩散加权成像（IVIM-DWI）和动态对比增强MRI（DCE-MRI）定量参数对高强度聚焦超声刀治疗子宫肌瘤疗效的比较。方法对60例子宫肌瘤患者进行高强度聚焦超声消融术，所有患者在术前1周、术后48 h及术后3月分别行IVIM-DWI及DCE-MRI检查，通过相关参数（ADC、eADC、StandardADC、f值、D值、D*值、MSI、SER）对同一肌瘤比较IVIM-DWI与DCE-MRI在消融和未消融区域的差异，分析两种扫描参数之间是否具有相关性。结果术后48 h、术后3月的DCE-MRI相关参数MSI、SER与IVIM-DWI相关参数D*与f值与术前差异具有统计学意义（P < 0.05），IVIM-DWI相关参数f与D*值与DCE-MRI相关参数MSI、SER有显著正相关性。结论IVIM-DWI所产生的伪彩图相较DCE-MRI对子宫肌瘤消融界限较难以区分，但IVIM-DWI相关参数仍能对子宫肌瘤HIFU术后早期病灶的血供及灌注情况提供一定的参考价值。

Comparison of IVIM-DWI and DCE-MRI in the treatment of uterine fibroids with high intensity focused ultrasound knife

ObjectiveTo compare the efficacy of IVIM-DWI and DCE-MRI in the treatment of uterine fibroids with highintensity focused ultrasound scalpel.Methods60 patients with hysteromyoma underwent high intensity focused ultrasound ablation. IVIM-DWI and DCE-MRI were performed in all patients 1 week before operation, 48 hours after operation and 3 months after operation respectively. The differences between IVIM-DWI and DCE-MRI in ablated and UN ablated areas were compared between IVIM-DWI and DCE-MRI through relevant parameters (ADC, eADC, standardABC, f value, D value, D*value, MSI, SER). The correlation between the two scanning parameters was analyzed.ResultsThe values of D* and F related with IVIM-DWI and the MSI, SER value of DCE-MRI at 48 h and 3 months after operation were significantly different from those before operation (P < 0.05). And there was a significant positive correlation between the values of F and D* of IVIMDWI and MSI and SER of DCE-MRI.ConclusionCompared with DCE-MRI, IVIM-DWI can not distinguish the ablation boundary of hysterical, but the parameters of IVIM-DWI can still provide some reference value for the blood supply and perfusion of uterine leiomyoma in the early stage after HIFU.