术前DTI纤维束示踪成像定量参数与高强度聚焦超声消融子宫肌瘤疗效的相关性研究

目的探讨术前DTI纤维束示踪成像定量参数与高强度聚焦超声(HIFU)消融子宫肌瘤疗效的相关性,以此来评估定量参数预测疗效的价值。方法将15例共27个子宫肌瘤患者于HIFU术前及术后1天内行常规MRI扫描及DTI扫描,测量术前肌瘤的MD值、FA值、纤维束密度、最长纤维束长度及平均纤维束长度与HIFU治疗的消融率进行相关性研究。结果肌瘤的MD值、纤维束密度与消融率为负相关,FA值与消融率为正相关,最长纤维束长度、平均纤维束长度与消融率不存在相关性。以消融率>0.75作为消融效果良好,FA值的曲线下面积为0.76。结论不同DTI定量参数的肌瘤HIFU消融疗效不一,MD值及纤维束密度与消融率呈负相关,FA值呈正相关,MD值及纤维束密度越小,FA值越大的子宫肌瘤消融效果更优,术前DTI纤维束示踪成像定量参数对于HIFU疗效的预测有一定价值。

The Predictive Value of Quantitative DTI Fibre Tractography Metrics for Ablation Effect of High Intensity Focused Ultrasound in Treating Uterine Fibroids

Objective To investigate the correlation between quantitative parameters of preoperative DTI fibre tractography and HIFU ablation of uterine fibroids,in order to evaluate the predictive value of metrics for ablation effect of HIFU in treating uterine fibroids.Methods Routine MRI scanning and DTI scan at a 3.0 T MRI scanner was performed on 15 patients with 27 uterine fibroids,FA value,density of fiber bundle,maximum length of fiber bundle,average length of fiber bundle and the NPVR of HIFU treatment were measured.The correlation between these quantitative parameters and NPVR of HIFU treatment were analyzed using Spearman correlation or Pearson correlation.Results The MD value,DFB and NPVR were negatively correlated.FA value was positively correlated with NPVR,and there was no correlation between the MLFB,ALFB and NPVR.The area under the ROC curve of FA value was 0.76 while the NPVR greater than 0.75 was considered as a good ablation effect.Conclusion The HIFU ablation effects of fibroids with different DTI quantitative parameters were different,MD value and DFB were negatively correlated with NPVR,and FA value was positively correlated.The smaller the MD value and the DFB,the greater the FA value is,the better the ablation effect of the uterine fibroids.The quantitative parameters of preoperative DTI fibre tractography have certain value for the prediction of HIFU efficacy.