摘要
目的研究灰阶超声在经皮微波消融(PMWA)治疗子宫肌层良性病变消融过程中及消融后期消融区声像图表现及其临床意义。方法选择2007年8月至2015年6月于解放军总医院行经皮微波消融治疗的患者588例,其中子宫肌瘤患者255例,子宫腺肌病患者333例,消融过程中及消融后3、6、9、12及24个月,灰阶超声观察消融区声像图表现,并与磁共振成像表现对比。结果消融过程中588例子宫肌层病变灰阶超声声像图表现为以微波辐射点为中心动态扩散的高回声,随微波辐射时间延长高回声范围逐渐增大,直至消融停止。消融结束后即刻所有病例消融区仍呈高回声,但无血流信号,静脉造影无血流灌注。随着随访时间延长所有病例消融区病变回声逐渐减低,呈不均质回声,但整体回声仍高于周围正常子宫肌层。3个月后开始消融区病变出现灶状无回声区,12个月后无回声区逐渐缩小或消失,消融针道呈条状高回声,24个月时消融针道高回声仍清晰可见。超声表现提示患者消融效果较好,治疗病灶逐渐吸收。结论经皮微波消融治疗子宫肌层病变过程中及治疗后灰阶超声声像图特点鲜明,可实时监测消融过程,也可后期评估病灶转归。
Objective To investigate the imaging manifestation and clinical significance of gray-scale ultrasonography during and after ultrasound-guided percutaneous microwave ablation（PMWA） for benign uterine myometrium lesions. Methods A total of 588 patients, 255 with leiomyomas and 333 with adenomyoma, who underwent PMWA between August 2007 and June 2015 were studied. The echo and blood supply characteristics of the lesions were observed with gray-scale ultrasonography before ablation and 3, 6, 9, 12, 24 months after ablation. During the ablation, the echo range of the ablated area was monitored with ultrasonography. Results A total of 588 cases was included in the study, including 255 uterus fibroid cases and 333 adenomyosis cases. In the process of ablation, gray scale ultrasound presented as diffused hyper-echo from the seam of microwave electrode. The range of hyper-echo gradually increased as along with the time of ablation, until the ablation stopped. The ablation area showed hyperecho without color signal immediately after PMWA, and no contrast agent perfusion by contrast-enhanced ultrasonography. As the follow-up time was prolonged, the echo of ablation area was gradually decreased, and became not homogeneous. Echoless area was showing after 3 months, and disappeared gradually after 12 months. The ablation needle tracks presented as hyperechoic strips and were still visible after 24 months. Conclusions The imaging characteristics of gray-scale ultrasonography during and after PMWA are so featured that it can monitor the ablation process in real time, and evaluate the outcome of lesions in the late stage.
出处
《中华医学超声杂志（电子版）》
CSCD
2016年第2期113-116,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
基金
国家自然科学基金面上项目(81371562)
关键词
超声检查
子宫肌瘤
子宫腺肌病
微波
消融术
Ultrasonography
Leiomyoma
Adenomyoma
Microwaves
Catheter ablation
