the Medical Ultrasound Center, Northwest Women's and Children's Hospital, Shaanxi, China.
J Ultrasound Med. 2019 Jun;38(6):1511-1517. doi: 10.1002/jum.14838. Epub 2018 Oct 4.
To assess the predictive significance of quantitative perfusion parameters from contrast-enhanced ultrasound (CEUS) for the therapeutic response to high-intensity focused ultrasound (HIFU) ablation in patients with uterine fibroids.
A total of 263 patients with single uterine fibroids were treated with HIFU ablation under ultrasound guidance. The arrival time, peak time, enhancement time, enhancement intensity, and enhancement rate were evaluated with pretreatment CEUS. According to a nonperfused volume ratio evaluation by posttreatment magnetic resonance imaging, all patients were assigned to groups with volume ratios of 70% or higher and lower than 70%. Then the predictive performances of different parameters for ablation efficacy were studied.
The arrival time, peak time, and enhancement time in the group with a nonperfused volume ratio of 70% or higher were longer than those in the group with a volume ratio lower than 70% (mean ± SD, 16.7 ± 3.5, 26.5 ± 4.9, and 10.2 ± 2.6 seconds, respectively, versus 13.3 ± 4.2, 20.8 ± 5.4, and 7.6 ± 2.3 seconds), whereas patients with a volume ratio of 70% or higher had a lower mean enhancement intensity and enhancement rate than those with a volume ratio lower than 70% (29.7 ± 16.7 dB and 3.2 ± 1.5 dB/s versus 63.2 ± 26.3 dB and 8.6 ± 4.3 dB/s; P < .05). The nonperfused volume ratio was negatively correlated with the enhancement intensity and enhancement rate (r = -0.631 and -0.712) but positively correlated with the arrival time, peak time, and enhancement time (r = 0.322, 0.456, and 0.477; P < .05). The areas under the receiver operating characteristic curve for the enhancement time, enhancement intensity, and enhancement rate were 0.73, 0.79, and 0.81 (P < .05).
Quantitative parameters from CEUS are potentially useful for evaluating the therapeutic effect of HIFU ablation for uterine fibroids.
评估超声造影（CEUS）定量灌注参数对高强度聚焦超声（HIFU）消融治疗子宫肌瘤的预测意义。
共 263 例单发子宫肌瘤患者在超声引导下行 HIFU 消融治疗。术前 CEUS 评估到达时间、峰值时间、增强时间、增强强度和增强率。根据术后磁共振成像评估的无灌注体积比，所有患者分为体积比为 70%或更高和低于 70%两组。然后研究不同参数对消融效果的预测性能。
体积比为 70%或更高组的到达时间、峰值时间和增强时间长于体积比低于 70%组（均值±标准差，分别为 16.7±3.5、26.5±4.9 和 10.2±2.6 秒，13.3±4.2、20.8±5.4 和 7.6±2.3 秒），而体积比为 70%或更高组的平均增强强度和增强率低于体积比低于 70%组（29.7±16.7 dB 和 3.2±1.5 dB/s，63.2±26.3 dB 和 8.6±4.3 dB/s；P<0.05）。无灌注体积比与增强强度和增强率呈负相关（r=-0.631 和-0.712），与到达时间、峰值时间和增强时间呈正相关（r=0.322、0.456 和 0.477；P<0.05）。增强时间、增强强度和增强率的受试者工作特征曲线下面积分别为 0.73、0.79 和 0.81（P<0.05）。
CEUS 的定量参数可能有助于评估 HIFU 消融治疗子宫肌瘤的疗效。
Zotero 插件