摘要
目的探讨HIFU对MR T2WI不同信号子宫肌瘤的消融效果及安全性。方法对156例患者共210个子宫肌瘤行HIFU消融治疗。根据术前MR T2WI表现分为低信号组、等信号组、高信号组及混杂信号组,比较各组间术前肌瘤体积、术中消融治疗参数(声源功率、辐照时间、治疗剂量及治疗强度)、能效因子、术后消融率、肌瘤缩小率及术中、术后不良反应发生率的差异。结果 4组间术前肌瘤体积(χ^2=14.720,P=0.002)、术中辐照时间(F=10.422,P<0.001)、治疗剂量(χ^2=30.973,P<0.001)、能效因子(F=3.953,P=0.009)、消融率(F=4.313,P=0.006)差异均有统计学意义。低信号组术前肌瘤体积明显小于高信号组(P=0.032)及混杂信号组(P=0.029);高信号组术中辐照时间明显长于低信号组(P<0.001)及混杂信号组(P=0.006),治疗剂量明显大于低信号组(P<0.001)、等信号组(P=0.023)及混杂信号组(P=0.013)。高信号组能效因子明显高于且消融率明显低于低信号组(P=0.016、0.003)、等信号组(P=0.012、0.006)及混杂信号组(P=0.002、0.003)。术中及术后均无严重并发症发生,且4组间放射痛、皮肤烫伤、治疗区疼痛等术中不良反应及阴道排液、下腹部疼痛、骶尾部疼痛等术后不良反应差异均无统计学意义(P均>0.05)。结论 HIFU治疗对MR T2WI不同信号的子宫肌瘤均安全、有效。但其中高信号肌瘤消融难度较大,术后疗效相对较差。
Objective To investigate the ablation effect and safety of HIFU for uterine fibroids with different MR T2 WI signals. Methods Totally 156 patients with 210 uterine fibroids were treated with HIFU ablation. According to preoperative MR T2 WI performances, uterine fibroids were divided into low signal group, equal signal group, high signal group and mixed signal group. The preoperative fibroid volume and intraoperative therapeutic dose parameters(sound source power, irradiation time, therapeutic dose and treatment intensity), energy efficiency factor, postoperative ablation rate, fibroid reduction, as well as the incidence of intraoperative and postoperative adverse reactions were compared among 4 groups. Results There were statistical differences of preoperative fibroid volume(χ^2=14.720, P=0.002), irradiation time(F=10.422, P<0.001), therapeutic dose(χ^2=30.973, P<0.001), energy efficiency factor(F=3.953, P=0.009) and ablation rate(F=4.313, P=0.006) among 4 groups. The volume of preoperative fibroids in low signal group was significantly lower than that in high signal group(P=0.032) and mixed signal group(P=0.029), respectively. The irradiation time in high signal group was significantly longer than that in low signal group(P<0.001) and mixed signal group(P=0.006), while the treatment dose was significantly greater than that in low signal group(P<0.001), equal signal group(P=0.023) and mixed signal group(P=0.013), respectively. High signal group had higher energy efficiency factors and lower ablation rate than low signal group(P=0.016, 0.003), equal signal group(P=0.012, 0.006) and mixed signal group(P=0.002, 0.003). No serious complication occurred during and after operation. And there were no significant difference of intraoperative and postoperative adverse reactions, such as radiation pain, skin burns, pain in treatment area, vaginal discharge, lower abdominal pain and appendix pain was found among 4 groups(all P>0.05). Conclusion HIFU treatment is safe and effective for uterine fibroids with different sign
作者
刘玉婷
谢晓绘
官孝萍
申恒春
LIU Yuting;XIE Xiaohui;GUAN Xiaoping;SHEN Hengchun(Department of Obstetrics and Gynecology,the Affiliated Hospital of Southwestern Medical University,Luzhou 646000,China;Department of Obstetrics and Gynecology,Neijiang First People's Hospital,Neijiang 641000,China)
出处
《中国介入影像与治疗学》
北大核心
2019年第6期349-353,共5页
Chinese Journal of Interventional Imaging and Therapy
关键词
子宫肿瘤
磁共振成像
信号
高强度聚集超声
治疗结果
uterine neoplasms
magnetic resonance imaging
signal
high-intensity focused ultrasound ablation
treatment outcome
