Zhao Wen-Peng, Chen Jin-Yun, Chen Wen-Zhi
State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, P.R. China; Department of Interventional Ultrasound, Chinese People's Liberation Army General Hospital, Beijing 100853, P.R. China.
State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, P.R. China.
Exp Ther Med. 2016 Jan;11(1):328-334. doi: 10.3892/etm.2015.2879. Epub 2015 Nov 18.
The aim of the present study was to investigate the efficacy of dynamic contrast-enhanced magnetic resonance imaging (MRI) in predicting the outcome of using ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation for the treatment of uterine fibroids with T2 hyperintensity under MRI. A total of 131 uterine fibroids from 131 patients that appeared hyperintense under T2-weighted MRI were analyzed. The uterine fibroids were subjectively categorized into slight, irregular or regular enhancement groups, according to pretreatment dynamic contrast-enhanced MRI in the arterial phase within 60 sec after the injection of gadolinium. The non-perfused volume (NPV), which is indicative of successful ablation, was represented as the non-perfused area inside the uterine fibroids on enhanced MRI scans following treatment. Additionally, the treatment duration, treatment efficiency, sonication duration, energy efficiency ratio and any adverse events were recorded. The results indicated that the average NPV ratio for all the treated fibroids was 68.5%, while the average NPV ratios for fibroids with slight, irregular or regular enhancement were 84.7, 70.6 and 57.1%, respectively. Fibroids with regular enhancement were associated with the lowest NPV ratio and the lowest treatment efficiency, but exhibited the highest energy effect ratio and an elevated risk of severe adverse effects. The results of the present study indicate that hyperintense uterine fibroids with slight and irregular enhancement in the arterial phase of dynamic contrast-enhanced MRI are suitable for USgHIFU treatment. By contrast, uterine fibroids with regular enhancement were associated with the lowest treatment efficacy and safety.
本研究的目的是探讨动态对比增强磁共振成像（MRI）在预测采用超声引导高强度聚焦超声（USgHIFU）消融治疗MRI下T2高信号子宫肌瘤疗效方面的作用。分析了131例患者的131个在T2加权MRI下呈高信号的子宫肌瘤。根据注射钆后60秒内动脉期的预处理动态对比增强MRI，将子宫肌瘤主观分为轻度、不规则或规则强化组。非灌注体积（NPV）表示治疗后增强MRI扫描中子宫肌瘤内的非灌注区域，它表明消融成功。此外，记录治疗持续时间、治疗效率、超声处理时间、能量效率比及任何不良事件。结果表明，所有治疗肌瘤的平均NPV率为68.5%，而轻度、不规则或规则强化肌瘤的平均NPV率分别为84.7%、70.6%和57.1%。规则强化的肌瘤NPV率最低且治疗效率最低，但能量效应比最高且严重不良反应风险升高。本研究结果表明，动态对比增强MRI动脉期轻度和不规则强化的高信号子宫肌瘤适合USgHIFU治疗。相比之下，规则强化的子宫肌瘤治疗效果和安全性最低。
