Zhang Yan, Zhang Meiwu, Fan Xiaoxiang, Mao Dafeng
Department of Interventional Therapy, Ningbo No. 2 Hospital, Ningbo, Zhejiang 315010, P.R. China.
Exp Ther Med. 2017 Nov;14(5):5103-5108. doi: 10.3892/etm.2017.5171. Epub 2017 Sep 21.
Contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) were compared in evaluating the short-term effects of microwave ablation (MWA) on uterine fibroids. A total of 60 patients with uterine fibroids treated by MWA were enrolled in the experimental group during their two-year follow-up period according to the inclusion criteria. Conventional two-dimensional US, MRI and CEUS were performed to determine the volume reduction and the fibroid residue by displaying the size, echo and signal intensity of fibroids prior to and after MWA treatment. As the control group, 60 consecutive patients were recruited on their follow-up visit at least two years after MWA treatment of uterine fibroids. Significant differences were observed in the wash-in rate (WiR) of the fibroid tissue, start time difference, rise time ratio (RTR) and WiR ratio between the experimental and control groups (P<0.05). However, the WiR of fibroid vessel, total area under the curve of fibroid vessel and tissue, and rise time difference (RTD) between fibroid vessel and tissue did not display any significant differences between the two groups. Fibroids were either reduced in volume or cured by MWA therapy in patients with uterine fibroids. The reductions in volume of hypointense, isointense and hyperintense fibroids were 62.42±18.13, 53.27±10.05 and 47.43±9.56%, respectively, on T1-weighted imaging (T1WI). On T2WI, the corresponding reductions were 67.32±32.63, 59.36±19.36 and 42.63±10.37%, respectively. The higher the signal intensity on T1WI and T2WI, the lower the reduction in volume. It is indicative that different blood supply to fibroids results in different ablation. CEUS was proved to be more effective than MRI in evaluating the effects of MWA on uterine fibroids during the first postoperative year.
对比增强超声(CEUS)和磁共振成像(MRI)在评估微波消融(MWA)治疗子宫肌瘤的短期疗效方面进行了比较。根据纳入标准,在两年随访期内,共有60例接受MWA治疗的子宫肌瘤患者被纳入实验组。在MWA治疗前后,通过显示肌瘤的大小、回声和信号强度,采用传统二维超声、MRI和CEUS来确定肌瘤体积缩小情况及肌瘤残留情况。作为对照组,选取60例在子宫肌瘤MWA治疗至少两年后的随访患者。实验组与对照组在肌瘤组织的增强率(WiR)、起始时间差、上升时间比(RTR)及WiR比方面存在显著差异(P<0.05)。然而,两组在肌瘤血管的WiR、肌瘤血管和组织的曲线下总面积以及肌瘤血管与组织之间的上升时间差(RTD)方面未显示出任何显著差异。子宫肌瘤患者经MWA治疗后肌瘤体积缩小或治愈。在T1加权成像(T1WI)上,低信号、等信号和高信号肌瘤的体积缩小率分别为62.42±18.13%、53.27±10.05%和47.43±9.56%。在T2WI上,相应的缩小率分别为67.32±32.63%、59.36±19.36%和42.63±10.37%。T1WI和T2WI上信号强度越高,体积缩小率越低。这表明肌瘤不同的血供导致不同的消融效果。在评估术后第一年MWA对子宫肌瘤的疗效方面,CEUS被证明比MRI更有效。