张佩蒂,杨晓,郑建民,刘海静,庞丽娜,丁雷,罗文.MR引导聚焦超声治疗子宫腺肌瘤前、后超声造影参数与疗效的相关性[J].中国介入影像与治疗学,2024,21(5):257-261
MR引导聚焦超声治疗子宫腺肌瘤前、后超声造影参数与疗效的相关性
Correlation of contrast-enhanced ultrasound parameters of adenomyoma before and after MR-guided focused ultrasound surgery with therapeutic efficacy
投稿时间:2024-02-19  修订日期:2024-04-04
DOI:10.13929/j.issn.1672-8475.2024.05.001
中文关键词:  子宫肿瘤  超声疗法  超声检查
英文关键词:uterine neoplasms  ultrasonic therapy  ultrasonography
基金项目:空军军医大学临床研究项目(2022LC2217)。
作者单位E-mail
张佩蒂 空军军医大学西京医院超声科, 陕西 西安 710032  
杨晓 空军军医大学西京医院超声科, 陕西 西安 710032  
郑建民 空军军医大学西京医院放射科, 陕西 西安 710032  
刘海静 空军军医大学西京医院超声科, 陕西 西安 710032  
庞丽娜 空军军医大学西京医院超声科, 陕西 西安 710032  
丁雷 空军军医大学西京医院超声科, 陕西 西安 710032  
罗文 空军军医大学西京医院超声科, 陕西 西安 710032 lwdd1234@fmmu.edu.cn 
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中文摘要:
      目的 观察MR引导聚焦超声(MRgFUS)治疗子宫腺肌瘤前、后超声造影(CEUS)参数与疗效的相关性。方法 回顾性分析26例接受MRgFUS的子宫腺肌瘤患者治疗前及治疗后24 h、1个月、6个月子宫超声及CEUS,以及治疗前和治疗后即刻MRI;对比治疗前CEUS与MRI所示病灶体积,治疗后即刻MRI与治疗后24 h CEUS所示非灌注体积(NPV),基于治疗后24 h的CEUS结果计算消融率。观察病灶治疗前、治疗后24 h血流评分及二者之和,以及治疗前、后1及6个月痛经数字评分量表(NRS)评分及其变化率,分析CEUS参数与疗效的相关性。结果 CEUS与MRI所示病灶体积及NPV差异均无统计学意义(P均>0.05)。治疗后24 h病灶消融率为(58.11±24.92)%。治疗前及治疗后24 h病灶血流评分及二者之和分别为2.00(2.00,2.00)、1.00(1.00,1.00)及3.50(3.00,3.50),治疗前与治疗后24 h差异有统计学意义(Z=-4.463,P<0.001)。治疗前、治疗后1及6个月,NRS评分分别为5.00(4.00,6.00)、3.00(2.00,4.00)及2.00(1.00,3.00),差异均有统计学意义(P均<0.01);治疗后1及6个月NRS评分变化率分别为35.42%(23.75%,50.00%)及60.00%(50.00%,77.08%)。治疗前及治疗后24 h病灶血流评分及二者之和均与消融率呈负相关(rs=-0.552、-0.820、-0.745),与治疗后6个月NRS评分呈正相关(rs=0.513、0.552、0.496)而与治疗后6个月NRS评分变化率均呈负相关(rs=-0.525、-0.479、-0.531);治疗后24 h病灶消融率与治疗后6个月NRS评分呈负相关(rs=-0.462)、与治疗后6个月NRS评分变化率呈正相关(rs=0.500)。结论 MRgFUS治疗子宫腺肌瘤前、后CEUS参数与疗效相关。
英文摘要:
      Objective To explore the correlation of contrast-enhanced ultrasound (CEUS) parameters of adenomyoma before and after MR-guided focused ultrasound surgery (MRgFUS) with the therapeutic efficacy. Methods Uterine ultrasound and CEUS data of 26 patients with adenomyoma before and 24 h, 1 and 6 months after MRgFUS, as well as MRI before and immediately after MRgFUS were retrospectively analyzed. The lesion volume shown on CEUS and MRI before MRgFUS, the non perfusion volume (NPV) of adenomyoma on MRI immediately after and CEUS 24 h after MRgFUS were compared. The ablation rate of lesions was calculated based on CEUS 24 h after MRgFUS. The focal blood flow score before, 24 h after MRgFUS and the sum of the two, also the numerical rating scale (NRS) score before and 1, 6 months after MRgFUS and the change rate were analyzed. The correlations of CEUS parameters with the efficacy of MRgFUS for treating adenomyoma were observed. Results No significant difference of lesion volume nor NPV on CEUS or MRI was found (both P>0.05). The ablation rate of lesions 24 h after treatment was (58.11±24.92)%. The focal blood flow score before, 24 h after MRgFUS and the sum of the two was 2.00 (2.00, 2.00), 1.00 (1.00, 1.00) and 3.50 (3.00, 3.50), respectively, with significant difference between before and 24 h after MRgFUS (Z=-4.463, P<0.001). NRS score was 5.00 (4.00, 6.00), 3.00 (2.00, 4.00) and 2.00 (1.00, 3.00) before treatment, 1 and 6 months after treatment, respectively, with significant differences at different time points (all P<0.01). The change rate of NRS score 1 and 6 months after treatment was 35.42% (23.75%, 50.00%) and 60.00% (50.00%, 77.08%), respectively. The lesion blood flow score before and 24 h after MRgFUS and the sum of the two were all negatively correlated with ablation rate (rs=-0.552, -0.820, -0.745), while positively correlated with NRS scores 6 months after treatment (rs=0.513, 0.552, 0.496) but negatively correlated with the change rate of NRS scores 6 months after treatment (rs=-0.525, -0.479, -0.531). The ablation rate 24 h after treatment was negatively correlated with NRS scores (rs=-0.462) while positively correlated with the change rate of NRS scores 6 months after treatment (rs=0.500). Conclusion CEUS parameters before and after treatment were correlated with the therapeutic efficacy of MRgFUS for treating adenomyoma.
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