“T2 边缘征”相关参数对高强度聚焦超声消融子宫肌瘤的影响。

Effect of "T2-rim sign" related parameters on high-intensity focused ultrasound ablation of uterine fibroids.

作者信息

Wang Lu, Liu Yang, Lin Jinfeng, Deng Jinghe, Yang Mengchu, Lv Fajin

机构信息

State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing 400016, China.

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China.

出版信息

Eur J Radiol. 2024 Dec;181:111767. doi: 10.1016/j.ejrad.2024.111767. Epub 2024 Sep 27.

DOI:10.1016/j.ejrad.2024.111767

PMID:39357287

Abstract

PURPOSE

To investigate the effect of "high-signal-intensity peripheral rim on T2-weighted MR images (T2-rim sign)" related parameters on non-perfused volume ratio (NPVR) after high-intensity focused ultrasound (HIFU) ablation of uterine fibroids.

METHODS

Data from 616 patients with uterine fibroids treated with HIFU were retrospectively analyzed. Univariate and multivariate logistic regression was used to analyze the factors influencing the ablation effect. The effect of T2-rim sign on ablation parameters and results was also analyzed. Spearman correlation analysis was used to compare the correlation between coverage ratio, average thickness of T2-rim sign and NPVR in 207 cases of fibroids with T2-rim sign.

RESULTS

The presence of T2-rim sign was an independent risk factor affecting the ablation effect. The coverage ratio of T2-rim sign was negatively correlated with treatment efficiency (r = -0.174, p = 0.012) and NPVR (r = -0.186, p = 0.007), and positively correlated with energy efficiency factor (EEF) (r = 0.156, p = 0.024). The average thickness of T2-rim sign was positively correlated with treatment intensity (r = 0.203, p = 0.003) and negatively correlated with NPVR (r = -0.363, p < 0.001). There was a negative correlation between the average thickness of the T2-rim sign and NPVR in isointense fibroids (r = -0.484, p < 0.001).

CONCLUSION

The presence of T2-rim sign increases the difficulty of ablation and reduces the ablation effect. In clinical practice, the presence and related parameters of T2-rim sign should be fully considered when screening for HIFU indications and formulating treatment plans.

摘要

目的

探讨高强度聚焦超声（HIFU）消融子宫肌瘤后，T2加权磁共振成像（T2WI）上的“高信号外周环（T2环征）”相关参数对无灌注体积比（NPVR）的影响。

方法

回顾性分析616例行HIFU治疗的子宫肌瘤患者的数据。采用单因素和多因素logistic回归分析影响消融效果的因素。同时分析T2环征对消融参数及结果的影响。对207例有T2环征的肌瘤，采用Spearman相关分析比较T2环征覆盖率、平均厚度与NPVR之间的相关性。

结果

T2环征的存在是影响消融效果的独立危险因素。T2环征覆盖率与治疗效率（r = -0.174，p = 0.012）和NPVR（r = -0.186，p = 0.007）呈负相关，与能量效率因子（EEF）呈正相关（r = 0.156，p = 0.024）。T2环征平均厚度与治疗强度呈正相关（r = 0.203，p = 0.003），与NPVR呈负相关（r = -0.363，p < 0.001）。等回声肌瘤中，T2环征平均厚度与NPVR呈负相关（r = -0.484，p < 0.001）。