团块与整体灰度变化在超声消融治疗子宫腺肌病的意义

目的:比较高强度聚焦超声(HIFU)消融治疗子宫腺肌病时,病灶出现团块状灰度变化及整体灰度变化的意义。方法:回顾性研究60例行超声消融治疗的子宫腺肌病患者的灰度变化情况,并与治疗后1 d的增强核磁共振成像(MRI)进行比较,分析团块状灰度变化及整体灰度变化与治疗剂量、治疗时间、治疗强度及MRI非灌注区的关系。结果:MRI显示团块状变化组和整体灰度变化组的腺肌病病灶大小差异无统计学意义(P>0.05)。治疗后1 d增强MRI检查发现,团块灰度变化组与整体灰度变化组在消融率、消融体积及治疗强度等方面差异无统计学意义(P>0.05);但整体灰度变化组的治疗剂量、治疗时间明显高于团块状灰度变化组(P<0.05)。两组患者治疗后即刻不良反应差异无统计学意义(P>0.05)。结论:HIFU治疗子宫腺肌病时,整体灰度变化也能明确反映消融效果,只要治疗强度达标,为降低过度治疗的风险,不必强求团块状灰度变化。

Comparison of Bolus and Integrate Changes of Gray-scale During the Treatment of Adenomyosis with High Intensity Focused Ultrasound

Objective:To compare the efficacy of different gray-scale changes in adenomyosis treatment by high intensity focused ultrasound(HIFU).Methods:Retrospective analysis the gray-scale changes of 60 uterine adenomyosis patients treated with HIFU,compared the gray-scale changes with contrast MRI 1 day after treatment,analysis the relationship of different gray-scale changes compared with the treatment dosage,treatment time,intensity of treatment and non-contrast area of MRI.Results:There was no significant different of non-contrast area of contrast MRI between bolus and integrate changes of gray-scale(P>0.05).The contrast MRI shows no statistic difference of ablation ratio,volume of ablation and treatment intensity between these two groups 1 day after the therapy procedure,however,the treatment dosage and treatment time of integrate gray-scale change group was much more than the bolus gray-scale change group(P<0.05).There was no significant statistic difference of side effects between two groups(P>0.05).Conclusions:This study shows that the integrate gray-scale changes can reflect the HIFU ablation efficacy of uterine adenomyosis.To reduce the risk of treatment,there were no necessary to get bolus gray-scale changes during the therapy.