摘要
目的:探讨磁共振扩散成像在子宫肌瘤高强度聚焦超声治疗后早期疗效评价中的价值。方法:15例患者共21个肌瘤经1次性HIFU刀治疗,术前、术后0.5及24h进行常规磁共振成像及DWI成像,观察肌瘤术前、术后在常规MRI、DWI上信号及ADC值变化特点并进行分析。结果:术后18个肌瘤增强扫描无灌注区,在DWI序列上均有不同程度的信号增高;肌瘤消融区术后0.5h平均ADC值[(1.287±0.213)×10-3 mm2/s]低于术前平均ADC值[(1.442±0.233)×10-3 mm2/s]及残留未消融区平均ADC值[(1.513±0.271)×10-3 mm2/s],术后24h复查,消融靶区平均ADC值[1.369±0.220)×10-3 mm2/s]回升。术前、术后0.5及24h消融区及残留未消融区平均ADC值差异有统计学意义(P<0.05);术后0.5h消融区在DWI上高信号主要分布于外周,中央部信号强度相对较低,呈较有特征性环形高信号改变,而且外周部ADC值低于中央部ADC值。结论:DWI和ADC值是早期评价子宫肌瘤高强度聚焦超声治疗术后疗效的有效手段。
Objective： To assess the early clinical value of MR diffusion-weighted imaging in uterine fibroids after high intensity focused ultrasound. Methods 15 patients with 21 uterine fibroids were treated by one-time HIFU technique. They had routine MRI （including plain and enhanced imaging） and DWI for three times：before the surgery,half an hour and 24 hours after the surgery. Compared with routine MRI, characteristics of changes in uterine fibroids in DWI signals and ADC values were analyzed. Resultss： After HIFU treatment,in non-perfusion areas on enhanced scan of 18 fibroids,the sig- nal intensity increased on DWI sequence;The mean ADC value[ （1. 287± 0. 213）× 10^-3 mm2/s] in the ablation area within half an hour after HIFU treatment was lower than both the values of pre-treatment [（1. 442±0. 233） × 10 ^-3mm2/s ] and of the non-ablation areas[（1. 513±0. 271）× 10^- 3mm2/s];The mean ADC value[（1. 369±0. 220）10 3mm2/s] within 24 hours after the HIFU treatment was increased （P〈0.05）. Half an hour after HIFU treatment, the high signals were mainly distributed in the peripheral area and the signals were relatively low in the central part of the ablation area. The changes could be classified as characteristic ring-shape high signals. Meanwhile, ADC value[（1. 175±0. 211）10^-3 mm2/s] at periph- ery was lower than that in the central part [（1. 380±0. 310）10^-3mm2/s]. Conclusion..DWI and ADC values are important in the early evaluation of ablated tissues after high intensity focused ultrasound treatment of uterine fibroids.
出处
《放射学实践》
2012年第12期1356-1360,共5页
Radiologic Practice
关键词
磁共振成像
扩散成像
子宫肿瘤
超声透入疗法
Magnetic resonance imaging
Diffusion weighted imaging
Uterine neoplasms
Phonophoresis
