非灌注区域MR T2WI信号评估HIFU消融子宫肌瘤的疗效

目的 探讨MR增强非灌注区域T2WI信号在评估子宫肌瘤HIFU术后疗效中的价值。方法 收集因子宫肌瘤接受HIFU消融治疗，并于术前和术后第3天、3个月和6个月接受MRI随访的90例患者，根据术后第3天非灌注区域内T2WI信号不同，将其分为低信号组（n=9）、等信号组（n=15）、混杂信号组（n=40）和高信号组（n=26），比较术后第3个月和6个月肌瘤残余体积的差异。结果 术后第3个月和第6个月，4组间肿瘤残余体积总体差异均有统计学意义（P均< 0.05）；两两比较，高信号组肌瘤残余体积均高于低信号组、等信号组和混杂信号组（P均< 0.05）；低信号组、等信号组和混杂信号组间差异均无统计学意义（P均>0.05）。术后患者未出现严重不良反应。结论 HIFU消融子宫肌瘤安全、有效；非灌注区域内T2WI信号可作为评估子宫肌瘤HIFU术后早期疗效的有效指标。

MR T2WI signal in non-perfusion region in evaluating curative effect of HIFU ablation of hysteromyoma

Objective To investigate the value of MR T2WI signal in non-perfusion region in evaluation on ablation effect of hysteromyoma with HIFU. Methods A total of 90 patients with hysteromyoma received HIFU ablation were enrolled. All patients underwent MRI before operation and the 3rd day, 3th month and 6th month after operation. Then the patients were divided into hypointense group (n=9), isointense group (n=15), heterogeneous group (n=40) and hyperintense group (n=26) based on T2WI signal in non-perfused region the 3rd day after ablation. The residual volume of fibroids at 3th month and 6th month after ablation were compared. Results There were significant differences in residual volume of fibroids among the 4 groups at 3th month and 6th month after ablation (both P<0.05); the residual volume in the hyperintense group was higher than that in hypointense group, isointense group and heterogeneous group (all P<0.05). There was no significant difference between each two of hypointense group, isointense group and heterogeneous group (all P>0.05). No serious adverse events occurred after HIFU ablation. Conclusion HIFU ablation of hysteromyoma is safe and effective. T2WI signal in non-perfusion region can be used to evaluate the early effect of hysteromyoma after HIFU ablation.