超声造影对射频热凝固治疗子宫肌/腺瘤病灶的评价

目的 研究超声造影对射频热凝固治疗子宫肌瘤、肌腺症手术前、后病灶的血流范围判断其预后。方法 选择不再有生育要求、超声提示子宫单发或多发肌瘤、肌腺症、功能性子宫出血及绝经后出血的患者共34例。术前常规子宫内膜诊刮，病理检查提示良性病变。子宫壁间肌瘤56枚，粘膜下肌瘤5枚，子宫内膜息肉及内膜息肉样变6例，年龄35～73岁，平均45.6岁。射频热凝固手术前、后均行子宫超声造影，观察病灶部位的血流情况。结果 术后超声造影显示：治疗后的肌瘤处于无增强区，呈圆形黑洞状；肌腺症病灶处偶见极少造影剂，呈规则或不规则黑洞状。结论 ①超声造影是一种简便、无创、能客观评价射频热凝固治疗子宫肌瘤、肌腺症病灶的治疗是否完善的新方法；②超声造影能即刻显示治疗是否彻底，对复查及预后提出可靠依据。③造影剂副作用发生率低，无肝、肾毒性。

Evaluation of the Influence of Radio Frequency Treatment Using Visualization under Ultrasonic of Hysteromyoma or Adenomyoma

Objective To research the value of visualization under ultrasonic to the hysteromyoma or adenomyoma where radiofrequency has worked on and predict the prognosis. Methods Make a selection of the patients aged from 35 to 73 years old,average 45.6, who have got married, and were demonstrated to have mono-or muhi-hysteromyoma or adenomyoma under ultrasonic. Ones with Functional uterine endomembrane breeding or bleeding after menapanse after the demonstrated with pathology, nonmalignant hyperplasia,were also counted in the total 34 cases. In all of them, amount of the hysteromyoma or adenomyoma was 56. Among them,the number of patients with sub-mucous membrane was 5, with endo-membrane polypus or meta- polypus was 6. Visualization under ultrasonic in uterine artery were made before and after the treatment of radio frequency. Make sure the conditions of the blood flow in uterus. Results The area of hysteromyoma displayed little resonic, 1 ike a black cave after radiofrequency. On the other hand, the visualization under ultrasonic show the area where should be the adenomyoma changed into a round cave, negtive with constrast-medium, or a irregular cave in adenomyoma, little remain in it. Conclusion （1）The visualization under ultrasonic is a new method with merit of simple management, harmless. The results show the objectivity in evaluating the area of radio-frequency treatment in hysteromyoma or adenomyoma.（2）In addition, it display the results of treatment inmediately if thoroughly and provid the reliable evidence for the recheck or prognosis. By the way, the side effect of radiopaque materials is rare. （3）The microvesicle shows harmless to liver or sidney.