彩色多普勒超声评价高强度聚焦超声治疗子宫肌瘤

目的 探讨高强度聚焦超声（HIFU）治疗子宫肌瘤的近期疗效及评价彩色多普勒血流显像（CDFI）在治疗前后的应用价值。方法 应用CDFI对经HIFU治疗的子宫肌瘤患者114例共175个肌瘤进行检测，观察治疗前后声像图的变化，并以治疗后瘤体的缩小程度为治疗有效指标对比分析，分析彩色多普勒血流信号变化与HIFU治疗效果的关系。结果 114例患者的175个肌瘤中，169个治疗后二维图像显示回声明显增强。158个治疗后3个月瘤体明显缩小，与治疗前相比差异有显著意义（P＜0．05）。143个治疗后血流信号消失，瘤体缩小；8个血流信号无明显变化，瘤体逐渐增大。24个血流信号明显减少，随着随访时间的延长，11例瘤体血流信号消失者中有9例血流信号重新变得丰富。结论 应用彩色多普勒超声技术能正确评价HIFU治疗子宫肌瘤的疗效，并在治疗后短期内指导临床治疗方案的修订及实施。

Value of color Doppler flow imaging in evaluating therapeutic effect of uterine leio myoma treated with high intensity focused ultrasound

Objective To evaluate the value of color Doppler flow imaging(CDFI) in the detection of uterine leiomyoma vas-cularity after treatment of high intensity focused ultrasound(HIFU) .Methods One hundred and fourteen patients with 175 uterine leio-myomas were treated by HIFU. Two-dimension ultrasound and CDFI were performed to observe the change of the size. echotexture and color flow of tumors after treatment and to analyze the relationship between them. Results One hundred and sixty nine of the 175 leio-myomas showed obvious acoustic enhancement in Two-dimension ultrasound after HIFU treatment. The mean size of leiomyomas decreased obviously three months after HIFU treatment and the difference was significantly comparing to the size before HIFU treatment(P <0.05). One hundred and forty three leiomyomas showed the blood supply disappeared and the mean size of these leiomyomas decreased significantly. eicht leiomyomas showed no CDFI signal change and these leiomyomas began to increase with following up and 24 leiomyomas showed the blood supply decreased obviously and these leiomyomas have different change in mean size. Conclusion CDFI can help to assess the therapeutic efficacy of HIFU treatment on uterine leiomyoma. It is also useful to establish proper protocol in the further treatment.