Department of Radiology, University Hospital of Cologne, Cologne, Germany.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Eur J Radiol. 2017 Dec;97:21-30. doi: 10.1016/j.ejrad.2017.10.006. Epub 2017 Oct 7.
To investigate the influence of a high-signal-intensity peripheral rim on T2-weighted MR images (i.e., T2-rim sign) on the immediate therapeutic responses of MR-guided high intensity focused ultrasound (MR-HIFU) ablation of uterine fibroids.
This retrospective study was approved by the institutional review board, and patient informed consent was obtained for MR-HIFU ablation. In total, 196 fibroids (diameter 6.2±2.6cm) in 123 women (age 43.4±5.0 years) who underwent MR-HIFU ablation from January 2013 to April 2016 were included. The effects of a T2-rim sign on the immediate therapeutic responses (non-perfused volume [NPV] ratio, ablation efficiency [NPV/treatment cell volume], ablation quality [grade 1-5, poor to excellent]) were investigated with univariable and multivariable analyses using generalized estimating equation (GEE) analysis. In multivariable analysis, T2 signal intensity ratio of fibroids-to-skeletal muscle, relative peak enhancement of fibroids, and subcutaneous fat thickness were also considered.
The presence of a T2-rim sign significantly lowered the NPV ratio (54.0±28.0% vs. 83.7±17.7%), ablation efficiency (0.6±0.5 vs. 1.3±0.6), ablation quality (3.1±1.2 vs. 4.2±0.8), (P<0.0001). GEE analysis showed that the presence of a T2-rim sign was independently significant for ablation efficiency and ablation quality (P<0.05).
Uterine fibroids with a T2-rim sign showed significantly poorer immediate therapeutic responses to MR-HIFU ablation.
探讨 T2 加权磁共振图像（即 T2 边缘信号）中高信号强度边缘对磁共振引导高强度聚焦超声（MR-HIFU）消融治疗子宫肌瘤即刻疗效的影响。
本回顾性研究经机构审查委员会批准，并获得了 123 名接受 MR-HIFU 消融治疗的女性患者（年龄 43.4±5.0 岁）的知情同意。共纳入 196 个子宫肌瘤（直径 6.2±2.6cm）。采用广义估计方程（GEE）分析，单变量和多变量分析探讨 T2 边缘信号对即刻治疗效果（无灌注体积[NPV]比、NPV/治疗细胞体积比、消融质量[1-5 级，从差到优]）的影响。在多变量分析中，还考虑了子宫肌瘤与骨骼肌的 T2 信号强度比、肌瘤的相对峰值增强和皮下脂肪厚度。
T2 边缘信号的存在显著降低了 NPV 比（54.0±28.0% vs. 83.7±17.7%）、NPV/治疗细胞体积比（0.6±0.5 vs. 1.3±0.6）和消融质量（3.1±1.2 vs. 4.2±0.8）（P<0.0001）。GEE 分析显示，T2 边缘信号的存在与 NPV 比和消融质量显著相关（P<0.05）。
具有 T2 边缘信号的子宫肌瘤在接受 MR-HIFU 消融治疗时即刻疗效显著较差。
