a Philips Healthcare Korea , MR Therapy , Seoul , Republic of Korea.
b Department of Radiology , Pham Ngoc Thach University of Medicine , Ho Chi Minh City , Viet Nam.
Int J Hyperthermia. 2018 May;34(3):306-314. doi: 10.1080/02656736.2017.1326634. Epub 2017 May 19.
To assess the relationship between magnetic resonance (MR) T1 perfusion-based classification and the outcome of MR-guided high intensity focused ultrasound treatment of adenomyosis, defined as nonperfused volume (NPV) ratio.
The adenomyosis of 31 women was classified into group A (time-signal intensity [SI] curve of adenomyosis lower than that of the myometrium) and group B (time-SI curve of adenomyosis equal to or higher than that of the myometrium) on the basis of time-SI curves on dynamic contrast enhanced (DCE) MR images acquired at screening. NPV ratios immediately after treatment and adenomyosis volume reduction ratios and symptom severity scores (SSS) at the six-month follow-up were retrospectively assessed. Univariate and multivariate analysis of pretreatment parameters conducted to assess independent factors impacting on immediate NPV ratio. All adverse effects were recorded.
The immediate NPV ratios in groups A and B were 89.2 ± 6.7% and 42.4 ± 19.0%, respectively. At the six-month follow-up, the adenomyosis volume reduction ratios in groups A and B were 0.27 ± 0.8 and 0.04 ± 0.1, respectively, with corresponding improvements of 0.7 ± 0.18 and 0.26 ± 0.25, respectively, in the mean transformed SSS. Univariate and multivariate analysis revealed that only T1 perfusion-based classification as an independent factor associated with the outcome of MR-guided high intensity focused ultrasound treatment. No serious adverse effects were reported.
Our novel classification method introduced in this study might be clinically beneficial in classifying adenomyosis for predicting the immediate outcome of MR-guided high intensity focused ultrasound treatment.
评估磁共振（MR）T1 灌注分类与 MR 引导高强度聚焦超声治疗子宫腺肌病的结果之间的关系，结果定义为无灌注体积（NPV）比值。
根据筛查时动态对比增强（DCE）MR 图像上的时间信号强度（SI）曲线，将 31 名女性的子宫腺肌病分为 A 组（子宫腺肌病的时间-SI 曲线低于子宫肌层）和 B 组（子宫腺肌病的时间-SI 曲线等于或高于子宫肌层）。回顾性评估治疗即刻后的 NPV 比值以及治疗 6 个月时的子宫腺肌病体积缩小率和症状严重程度评分（SSS）。对治疗前参数进行单因素和多因素分析，以评估对即刻 NPV 比值有影响的独立因素。记录所有不良事件。
A 组和 B 组的即刻 NPV 比值分别为 89.2±6.7%和 42.4±19.0%。在 6 个月的随访中，A 组和 B 组的子宫腺肌病体积缩小率分别为 0.27±0.8 和 0.04±0.1，相应的 SSS 均值变化率分别为 0.7±0.18 和 0.26±0.25。单因素和多因素分析显示，只有 T1 灌注分类是与 MR 引导高强度聚焦超声治疗结果相关的独立因素。未报告严重不良事件。
本研究中引入的新型分类方法可能对分类子宫腺肌病有临床益处，有助于预测 MR 引导高强度聚焦超声治疗的即刻结果。
