Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
Department of Medical Imaging, Zhongshan Hospital, Fudan University (Xuhui Branch), Shanghai 200000, China.
Clin Radiol. 2023 Jan;78(1):61-69. doi: 10.1016/j.crad.2022.09.112. Epub 2022 Oct 12.
To study the value of magnetic resonance imaging (MRI) parameters in predicting the efficacy of ultrasonic ablation of fibroids.
A total of 91 patients were divided into groups based on non-perfused volume (NPV) ratio and blood supply type. The preoperative MRI parameters were measured and analysed. A correlation analysis between the MRI parameters and the NPV ratio was performed. Receiver operating characteristic (ROC) curves were used to analyse and determine the cut-off value of MRI parameters to predict the ablation rate of fibroids.
The uterine fibroids group with an NPV ratio <80% and the group with an NPV ratio of ≥80% had significant differences in signal intensity (SI) at MRI T2-weighted imaging (WI), fibroid-to-rectus abdominis SI ratio (SIR) at T2WI, and blood supply type (p<0.05). There were no significant differences in fibroid volume, T2WI signal uniformity, and apparent diffusion coefficient (ADC) values. The ADC value and SI and SIR at MRI T2WI in the group with poor blood supply were lower than those in the group with a rich blood supply (p<0.05). SI at MRI T2WI correlated negatively with the NPV ratio. The cut-off values for SI and SIR at MRI T2WI of fibroids whose NPV ratio exceeds 80% were 220.58 and 1.315, respectively.
SI at MRI T2WI and blood supply type could be predictors of the efficacy of ablation. Ultrasonic ablation of fibroids with MRI T2WI hyperintensity and a rich blood supply had poor efficacy.
研究磁共振成像（MRI）参数在预测子宫肌瘤超声消融疗效中的价值。
将 91 例患者根据无灌注体积（NPV）比和供血类型进行分组，测量并分析术前 MRI 参数，分析 MRI 参数与 NPV 比的相关性，应用受试者工作特征（ROC）曲线分析和确定 MRI 参数预测肌瘤消融率的截断值。
NPV 比<80%的子宫肌瘤组和 NPV 比≥80%的子宫肌瘤组在 MRI T2 加权成像（WI）的信号强度（SI）、T2WI 的肌瘤与腹直肌 SI 比值（SIR）和供血类型方面存在显著差异（p<0.05），瘤体体积、T2WI 信号均匀性和表观扩散系数（ADC）值无显著差异。低供血组的 ADC 值及 T2WI 的 SI 和 SIR 均低于高供血组（p<0.05）。MRI T2WI 的 SI 与 NPV 比呈负相关。NPV 比超过 80%的肌瘤 MRI T2WI 的 SI 和 SIR 的截断值分别为 220.58 和 1.315。
MRI T2WI 的 SI 和供血类型可作为消融疗效的预测指标，MRI T2WI 高信号和丰富血供的子宫肌瘤超声消融疗效较差。
