Xia M, Jing Z, Zhi-Yu H, Jian-Ming C, Hong-Yu Z, Rui-Fang X, Yu Y, Yan-Li H, Bao-Wei D
1 Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.
Br J Radiol. 2014 Aug;87(1040):20130770. doi: 10.1259/bjr.20130770. Epub 2014 Jun 20.
To evaluate the feasibility of energy prediction of percutaneous microwave ablation (PMWA) upon uterine leiomyomas and adenomyosis by MRI.
63 patients (49 patients with 49 uterine leiomyomas and 14 patients with adenomyosis) who underwent ultrasound-guided PMWA treatment were studied during the period from June 2011 to December 2012. Before PMWA, contrast-enhanced MRI (ceMRI) was performed for all of the patients. Based on the signal intensity (SI) of T2 weighted MRI, uterine leiomyomas were classified as hypointense, isointense and hyperintense. During ablation, the output energy of the microwave was set at 50 W, and T11a microwave antennas were used. ceMRI was performed within 7 days after PMWA treatment. Non-perfused volume and energy required per unit volume were analysed statistically.
When unit volume of lesions was ablated, uterine adenomyosis needed more energy than did uterine leiomyomas, and hyperintense uterine leiomyomas needed more energy than did hypointense pattern.
MRI SI of uterine leiomyomas and uterine adenomyosis can be used to predict PMWA energy.
The conclusions indicate that MRI SI can be used to perform pre-treatment planning, which will make the treatment more precise.
通过磁共振成像(MRI)评估经皮微波消融(PMWA)治疗子宫平滑肌瘤和子宫腺肌病时能量预测的可行性。
对2011年6月至2012年12月期间接受超声引导下PMWA治疗的63例患者(49例子宫平滑肌瘤患者和14例子宫腺肌病患者)进行研究。在PMWA治疗前,对所有患者进行对比增强MRI(ceMRI)检查。根据T2加权MRI的信号强度(SI),将子宫平滑肌瘤分为低信号、等信号和高信号。消融过程中,微波输出能量设定为50W,使用T11a微波天线。在PMWA治疗后7天内进行ceMRI检查。对无灌注体积和单位体积所需能量进行统计学分析。
在消融单位体积的病灶时,子宫腺肌病比子宫平滑肌瘤需要更多能量,高信号子宫平滑肌瘤比低信号型需要更多能量。
子宫平滑肌瘤和子宫腺肌病的MRI SI可用于预测PMWA能量。
研究结论表明MRI SI可用于进行治疗前规划,这将使治疗更加精确。