From the Department of Radiology and Center for Imaging Science (Y.S.K., H.R., H.K.L.) and Department of Obstetrics and Gynecology (J.W.L., C.H.C., B.G.K., D.S.B.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea; and Department of Health Science and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University School of Medicine, Seoul, Korea (H.K.L.).
Radiology. 2016 Mar;278(3):925-35. doi: 10.1148/radiol.2015150608. Epub 2015 Aug 27.
To evaluate the relationships between T2 signal intensity and semiquantitative perfusion magnetic resonance (MR) parameters of uterine fibroids in patients who were screened for MR-guided high-intensity focused ultrasound (HIFU) ablation.
Institutional review board approval was granted, and informed consents were waived. One hundred seventy most symptom-relevant, nondegenerated uterine fibroids (mean diameter, 7.3 cm; range, 3.0-17.2 cm) in 170 women (mean age, 43.5 years; range, 24-56 years) undergoing screening MR examinations for MR-guided HIFU ablation from October 2009 to April 2014 were retrospectively analyzed. Fibroid signal intensity was assessed as the ratio of the fibroid T2 signal intensity to that of skeletal muscle. Parameters of semiquantitative perfusion MR imaging obtained during screening MR examination (peak enhancement, percentage of relative peak enhancement, time to peak [in seconds], wash-in rate [per seconds], and washout rate [per seconds]) were investigated to assess their relationships with T2 signal ratio by using multiple linear regression analysis. Correlations between T2 signal intensity and independently significant perfusion parameters were then evaluated according to fibroid type by using Spearman correlation test.
Multiple linear regression analysis revealed that relative peak enhancement showed an independently significant correlation with T2 signal ratio (Β = 0.004, P < .001). Submucosal intracavitary (n = 20, ρ = 0.275, P = .240) and type III (n = 18, ρ = 0.082, P = .748) fibroids failed to show significant correlations between perfusion and T2 signal intensity, while significant correlations were found for all other fibroid types (ρ = 0.411-0.629, P < .05).
In possible candidates for MR-guided HIFU ablation, the T2 signal intensity of nondegenerated uterine fibroids showed an independently significant positive correlation with relative peak enhancement in most cases, except those of submucosal intracavitary or type III fibroids.
评估在接受磁共振引导高强度聚焦超声（HIFU）消融治疗的患者中，子宫肌瘤 T2 信号强度与半定量灌注磁共振（MR）参数之间的关系。
本研究经机构审查委员会批准，并豁免了知情同意。回顾性分析了 2009 年 10 月至 2014 年 4 月期间 170 名因接受 MR 引导 HIFU 消融治疗而接受筛查性 MR 检查的妇女（平均年龄 43.5 岁，范围 24-56 岁）中 170 个最相关、非退变的子宫肌瘤（平均直径 7.3cm，范围 3.0-17.2cm）的资料。评估肌瘤 T2 信号强度与骨骼肌 T2 信号强度的比值作为肌瘤信号强度。分析筛查性 MR 检查中获得的半定量灌注 MR 成像参数（峰值增强、相对峰值增强百分比、达峰时间[秒]、流入率[每秒]和流出率[每秒]），采用多元线性回归分析评估它们与 T2 信号比的关系。然后，根据肌瘤类型，采用 Spearman 相关检验评估 T2 信号强度与独立显著灌注参数之间的相关性。
多元线性回归分析显示，相对峰值增强与 T2 信号比呈独立显著相关性（β=0.004，P<.001）。黏膜下腔内型（n=20，ρ=0.275，P=.240）和 III 型（n=18，ρ=0.082，P=.748）肌瘤的灌注与 T2 信号强度之间无显著相关性，而其他类型的肌瘤均存在显著相关性（ρ=0.411-0.629，P<.05）。
在可能接受 MR 引导 HIFU 消融治疗的候选患者中，大多数非退变子宫肌瘤的 T2 信号强度与相对峰值增强呈独立显著正相关，除了黏膜下腔内型或 III 型肌瘤外。
