摘要
目的探讨子宫肌瘤超声特征与高强度聚焦超声(HIFU)消融疗效关系及与病理组织的对照分析情况。方法选取2018年5月至2019年7月我院行HIFU消融治疗的子宫肌瘤患者52例,共72个肌瘤,术前进行超声检查,以患者正常子宫肌层对照,根据子宫肌瘤内部回声强度分为高回声组、等回声组、低回声组,并记录子宫肌瘤的位置、大小、回声强度及血流信号,随后行超声引导下子宫肌瘤穿刺活检,半小时后行HIFU消融治疗,术前及术后1周行盆腔核磁共振检查评估HIFU消融的效果。结果所有患者均顺利完成HIFU治疗,术前3组子宫肌瘤患者的年龄、体质量指数(BMI)、腹壁厚度、子宫体积、子宫位置、肌瘤体积、肌瘤的位置和肌瘤类型比较的差异无统计学意义(P>0.05);HIFU消融治疗参数比较:辐照时间、治疗时间、辐照能量、能效因子比较,高回声组<等回声组<低回声组,组间比较的差异有统计学意义(P<0.05);而消融率比较,高回声组(74.64±16.32)%>等回声组(59.39±13.21)%>低回声组(47.11±11.26)%,组间比较差异有统计学意义(P<0.05)。穿刺病理结果:高回声组中以普通未变性肌瘤(24/31,77.4%),低回声组以富于细胞型(13/24,54.2%)及透明变性肌瘤(8/24,33.3%)为主,等回声组以普通未变性肌瘤(8/17,47.1%)及透明变性肌瘤(7/17,41.2%)为主,组间比较差异有统计学意义(P<0.05)。结论不同回声强度的子宫肌瘤HIFU消融效果存在差异,可能与肌瘤内部的病理成分及构架影响了声阻抗及热沉淀有关,为术前初步预测子宫肌瘤HIFU消融的效果提供有效声学信息。
Objective To investigate the relationship between the ultrasound features of uterine fibroids and the curative effect of high intensity focused ultrasound(HIFU) ablation and the comparative analysis of pathological tissue.Methods A total of 52 patients with uterine fibroids who underwent HIFU ablation treatment in our hospital from May 2018 to July 2019 were selected, with a total of 72 fibroids.Ultrasound examination was performed before surgery, and the patients were compared with normal myometrium.The intensity was divided into high echo group, isoechoic group, and low echo group, and the position, size, echo intensity, and blood flow signal of uterine fibroids were recorded.Subsequently, ultrasound-guided uterine fibroids biopsy was performed, and HIFU ablation treatment was performed half an hour later.The pelvic MRI was performed before and one week after the operation to evaluate the effect of HIFU ablation.Results All patients successfully completed HIFU treatment.The age, body mass index(BMI), abdominal wall thickness, uterine volume, uterine position, fibroid volume, fibroid position, and fibroid type were compared among the three groups of uterine fibroids before surgery.The difference was not statistically significant(P> 0.05).Comparison of HIFU ablation treatment parameters: comparison of irradiation time, treatment time, irradiation energy, and energy efficiency factor, high echo group the isoecho group(59.39±13.21)%> the low echo group(47.11±11.26)%, comparison between groups The difference was statistically significant(P<0.05).Pathological results of puncture: common non-degenerating fibroids in the hyperechoic group(24/31, 77.4%), and low-echoic groups with rich cell types(13/24, 54.2%) and hyaline degenerating fibroids(8/24, 33.3%)), The common echo group was predominantly non-denaturing fibroids(8/17, 47.1%) and hyaline degenerating fibroids(7/17, 41.2%).There was a statistically significant difference between the groups(P<0.05).Conclusion The effects of HIFU ablation of uterine fibroids with different echo intensity are different, which may be related to the pathological components and structures inside the fibroids affecting the acoustic impedance and thermal deposition, which provide effective acoustic information for the preliminary prediction of the effect of HIFU ablation of uterine fibroids before surgery.
作者
丁桂升
陈圣
林宁
吴松松
李建卫
王大璇
高锐
DING Guisheng;CHEN Sheng;LIN Ning;WU Songsong;LI Jianwei;WANG Daxuan;GAO Rui(Department of Ultrasound,Fujian Provincial hospital,Provincial Clinical Medical College of Fujian Medical University,Fuzhou,Fujian 350001 China)
出处
《福建医药杂志》
CAS
2020年第2期37-40,共4页
Fujian Medical Journal
关键词
子宫肌瘤
高强度聚焦超声
超声特征
病理
uterine fibroids
high-intensity focused ultrasound
ultrasound features
pathology
