3.0 TMRI对子宫肌瘤高强度聚焦超声治疗后的早期效果评价

目的 采用3.0 TMRI平扫及增强扫描对子宫肌瘤高聚焦超声(HIFU)早期疗效评价.方法 33例子宫肌瘤患者,其中单发肌瘤20例,多发肌瘤13例,共59个,患者平均年龄(34.3±8.7)岁,所有患者均于HIFU术前及术后1 d行MRI平扫、增强扫描检查,观察并定量测定肌瘤、肌壁HIFU术前、后T2压脂、T2WI、T1WI平扫及增强扫描信号值,并计算肌瘤最大消融区面积,对其疗效进行评估.结果 59个肌瘤于HIFU术后在T1WI增强扫描序列均出现无强化的消融区,平均消融率达70.9%.MRI增强扫描消融区T1信号值与术前比较明显减低(P<0.01).术后消融区在T1平扫像上呈不同程度高信号,T2像上消融区范围显示不明确,但T2信号值较术前明显升高(P<0.01).MRI平扫所见术后T1信号增高区1.0 cm)肌壁T2压脂信号各组间均无统计学差别.结论 3.0 TMRI增强扫描可以直观、准确的显示肌瘤消融区,T1术后高信号区可以显示肌瘤HIUF术后坏死区,可以评价消融范围.

Early efficiency evaluation of 3.0T MRI on uterine fibroids after treated by high-intensity focused ultrasound

Objective Using 3.0T MRI unenhanced and enhanced MRI scanning to evaluate the early therapeutic effects of high-intensity focused ultrasound (HIFU) on uterine fibroids.Methods Thirty-three patients with uterine fibroids including 20 cases of solitary uterine fibroid and 13 cases of multiple uterine fibroids,a total of 59 uterine fibroids,whose mean age was (34.3±8.7) years,were enrolled in the study.All the patients underwent unenhanced MRI scan and enhanced MRI scan before HIFU and after HIFU to observe and calculate quantitatively the signal value of T2WI fat suppression, T2WI, unenhanced and enhanced T1WI of uterine fibroids and uterine wall,moreover, to calculate the maximum ablation area of fibroids and to evaluate the therapeutic effects.Results The 59 fibroids did not appear enhancement of ablation zone in T1W1 enhanced scan sequence after HIFU,with average ablation rate being 70.9%.The signal value of enhanced T1WI was significantly decreased,as compared with that before HIFU (P<0.01).The postoperative ablation zone showed different degree high signals in unenhanced T1 plain scan image,and the ablation zone range displayed unclearly in T2 image,and T2 signal value was significantly increased,as compared with that before HIFU (P<0.01).The high signal area of T1WI after postoperative MRI scan was smaller than that in the ablation area of enhanced MRI scan (P<0.01).The area of increased signal of enhanced T1WI was closely correlated to the ablation area of enhanced MRI scan (r=0.94).The signal intensity in muscle wall in solitary myoma group was significantly decreased after HIFU,as compared with that before HIFU (P<0.05).The signal intensity of T2WI fat suppression scan in muscle wall in multiple fibroids group was obviously decreased (P<0.05).There was no significant difference in the signal intensity of T2WI fat suppression scan in muscle wall at different distances to fibroids (<0.5cm,0.5~1.0cm,>1.0cm) among solitary uterine fibroid groups.Conclusion The 3.0T MRI enhanced scan can show the fibroid ablation zone directly and accurately, moreover, the high signal area of postoperative T1WI can display necrosis area of fibroids after HIFU and can evaluate the ablation range.