[超声消融治疗剂量下子宫肌瘤血供的多普勒血流成像特征]

[Doppler flow imaging characteristics of blood supply of uterine fibroids on the therapeutic dosage of ultrasound ablation].

作者信息

Chen Jin-yun, Chen Wen-zhi, Zhu Li, Tang Liang-dan, Deng Yong-bin, Liu Ying-jiang, Zou Jian-zhong, Bai Jin, Wang Zhi-biao

机构信息

College of Biomedical Engineering, Chongqing Medical University, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2011 Jun;46(6):403-6.

PMID:21781577

Abstract

OBJECTIVE

To explore the relationship between therapeutic dosage of ultrasound ablation in treatment of uterine fibroids and imaging characteristics of bloody supply of uterine fibroids by color Doppler ultrasound imaging.

METHODS

One hundred and forty-two patients with 168 fibroids were treated by ultrasound ablation. Before treatment, bloody supply of fibroids were classified into grade 0 - 4 by ultrasonography. Three patients lost follow-up with contrast MRI exam within 1 month after treatment, so 165 fibroids were enrolled in this study. Bloody supplies were 9 fibroids in grade 0, 34 fibroids in grade 1, 35 fibroids in grade 2, 55 fibroids in grade 3 and 32 fibroids in grade 4. After 1 month treatment, the treated area without blood supply and ratio of ablation were measured by contrast MRI to evaluate the efficacy of thermal ablation and compare status of blood supple based different therapeutic dosage. According to International Reditherapy for Society (SIR) standard, adverse effect and score of pain were evaluated.

RESULTS

(1) Ratio of ablation based: ratios of ablation were 79% in grade 0, 89% in grade 1, 92% in grade 2, 86% in grade 3, 71% in grade 4. It reached statistical difference when blood supply of grade 0 compared with those of grade 2 and 3 (P < 0.05) and blood supply of grade 4 compared with those of grade 1, 2, 3 (P < 0.05). (2) Factor of energy efficiency: factor of energy efficiency were 13.19 J/mm(3) in degree 0, 9.54 J/mm(3) in degree 1, 12.91 J/mm(3) in degree 2, 17.83 J/mm(3) in degree 3 and 28.10 J/mm(3) in degree 4. Factor of energy of ablation in degree 4 was significantly higher than those in degree 1, 2 and 3 blood supply (P < 0.05). It exhibit the positive relationship between blood supply and factor of energy of ablation (r = 0.354, P < 0.01). (3) Score of pain and adverse effect: nearly 85% (120/142) patients could tolerate this treatment very well. Those scores of pain were in range of 0 to 4. All patients did not extend their hospitalization and C to F of SIR standard was not recorded.

CONCLUSION

blood supply of myoma measured by ultrasound could predict dosage of ultrasound ablation, it could help select indicated well patients.

摘要

目的

通过彩色多普勒超声成像探讨超声消融治疗子宫肌瘤的治疗剂量与子宫肌瘤血供成像特征之间的关系。

方法

142例患有168个肌瘤的患者接受了超声消融治疗。治疗前，通过超声检查将肌瘤血供分为0 - 4级。3例患者在治疗后1个月内失访，未进行对比MRI检查，因此本研究纳入165个肌瘤。血供情况为0级9个肌瘤，1级34个肌瘤，2级35个肌瘤，3级55个肌瘤，4级32个肌瘤。治疗1个月后，通过对比MRI测量治疗区域的无血供情况和消融率，以评估热消融疗效，并比较不同治疗剂量下的血供状态。根据国际放射学会（SIR）标准，评估不良反应和疼痛评分。

结果

（1）基于消融率：0级消融率为79%，1级为89%，2级为92%，3级为86%，4级为71%。0级血供与2级和3级血供相比差异有统计学意义（P < 0.05），4级血供与1级、2级、3级血供相比差异有统计学意义（P < 0.05）。（2）能量效率因子：0级能量效率因子为13.19 J/mm³，1级为9.54 J/mm³，2级为12.91 J/mm³，3级为17.83 J/mm³，4级为28.10 J/mm³。4级血供的消融能量因子显著高于1级、2级和3级血供（P < 0.05）。血供与消融能量因子呈正相关（r = 0.354，P < 0.01）。（3）疼痛评分和不良反应：近85%（120/142）的患者能够很好地耐受这种治疗。疼痛评分在0至4分之间。所有患者均未延长住院时间，未记录到SIR标准中的C至F级情况。