DWI监测子宫肌瘤HIFU术后早期疗效的价值

目的:探讨DWI评价子宫肌瘤高强度聚焦超声(high-intensity focused ultrasound,HIFU)术后早期疗效的价值。方法:24例患者共26个肌瘤在HIFU术前1周及消融后1周行DWI、CE-MRI检查,分析残留肌瘤组织的DWI信号特征,并比较DWI与CE-MRI测得的残留肌瘤组织体积。结果:24例DWI、CE-MRI均能发现残留肌瘤组织;HIFU术后1周子宫肌瘤残留区DWI信号较前略升高;术后1周残留部分平均ADC值为(1.552±0.142)×10-3 mm2/s,较术前有升高,且差异有统计学意义(P<0.005)。DWI与CE-MRI对术后1周残留组织平均体积的测量,差异无统计学意义(P>0.05)。Pearson法显示,DWI与CE-MRI测量肌瘤残留部分体积呈高度相关(r=0.95,P<0.005)。结论:DWI是监测早期子宫肌瘤HIFU术后不完全消融非常有效的方法。

The value of DWI in monitoring the early-term effectiveness of high-intensity focused ultrasound ablation of hysteromyoma

Objective： To retrospectively analyze the early-term value of diffusion weighted imaging （DWI） features of hystero- myoma after high-intensity focused ultrasound （HIFU） incomplete ablation. Methods： Twenty-four patients with twenty-six hysteromyomas underwent HIFU ablation,DWI and CE-MRI was performed one week before and 1st week after HIFU. The feature of DWI signal and ADC value of the residual part of hysteromyoma was analyzed,the measured volume was compared in DWI and CE-MRI. Results：The residual part of hysteromyoma was found in DWI and CE-MRI. The signal intensity of the resid ual part of hysteromyoma in DWI sequence increased 1 week after HIFU ablation. The ADC value of the residual part of hyste romyoma was （1. 552± 0. 142） ×10^-3 mm2/s 1 week after HIFU ablation, was higher than the ADC value before operation, sig- nificant difference was found between them （P〈0. 005）. The mean volume of the residual part of hysteromyoma 1 week after HIFU ablation was measured in DWI and CE-MRI, no significant difference was found between DWI and CE-MRI （P〈0.05）. High correlation was observed in volume of the residual part of hysteromyoma between DWI and CE-MRI with Pearson analysis. Conclusion..DWI and ADC value are very useful means for monitoring the early-term effectiveness of incomplete abla- tion of hysteromyoma after HIFU ablation.