二维超声造影评价射频消融治疗子宫肌瘤效果的临床意义

目的评价二维超声造影（2D-CEUS）在射频消融（RFA）治疗子宫肌瘤中的意义。方法接受RFA治疗的子宫肌瘤患者110例,共176枚肌瘤,156枚为肌壁间肌瘤,20枚为黏膜下肌瘤,其中12枚为有蒂黏膜下肌瘤。全部病例在RFA前后1 d内进行2D-CEUS,观察病灶区血供变化,测量肌瘤体积、消融范围,得出灭活率。结果12枚有蒂黏膜下肌瘤完整取出。164枚在体肌瘤射频治疗后2D-CEUS表现：154枚肌瘤原部位无造影剂灌注,提示消融完全,灭活率达（98.30±22.03）%;10枚肌瘤边缘线性增强或瘤内片状增强区,考虑治疗不全,其灭活率仅为（51.09±1.96）%。结论 2D-CEUS可以客观反映肿瘤的血流灌注状态,对选择治疗方案和判断疗效有着较高的实用价值。

Clinical significance of assessment of the therapeutic effects of hysteromyomas treated with the radiofrequency ablation by two-dimensional contrast-enhanced sonography

Objective To evaluate the significance of two-dimensional contrast-enhanced ultrasound（2D-CEUS） in the radiofrequency ablation（RFA） treatment of hysteromyomas.Methods A total of 110 patients with 176 hysteromyomas were treated with RFA,including 156 intramural myomas and 20 submucous myomas（12 of those with pedicles）.2D-CEUS was performed within 1d before and one day after RFA treatment respectively.The blood supply of focal zone（FZ） was observed by 2D-CEUS.The volume of hysteromyomas and the coagulation necrosis rang were measured by 2D-CEUS.The average necrotic rate of hysteromyomas was calculated.Results After the RFA treatment,the 12 submucous myomas with pedicles were removed completely.The 2D-CEUS appearances of other 164 hysteromyomas were diverse after the RFA treatment,in which 154 FZs had no contrast infusion,indicating complete ablation,10 FZs appeared peripheral linear or small flaky enhancement,considering incomplete treatment.The average necrotic rate of the 154 hysteromyomas was（98.3±22.03） %,another 10 hysteromyomas was only（51.09±1.96）%.Conclusion 2D-CEUS can display features of the blood supply of hytersomyomas,which can be used as a credible index to choose available treatment and to evaluate the earlier therapeutic efficacy of hysteromyomas after RFA.