超声造影评价微波消融子宫腺肌病的疗效及应用价值
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摘要
目的探讨超声造影(Contrast Enhanced Ultrasound,CEUS)评价经皮穿刺微波消融(Percutaneous Microwave Ablation,PMWA)子宫腺肌病的疗效及应用价值。方法 31例PMWA术前经增强MRI证实为子宫腺肌病患者,分别于PMWA术前及术后1~2 d行CEUS检查,术后复查增强MRI,分析CEUS评价消融范围的准确性。术中及术后密切观察有无并发症及近期临床治疗效果。结果 31例子宫腺肌病行PMWA治疗后,CEUS显示子宫腺肌瘤消融后无造影剂灌注,消融体积为(49.4±29.8)cm3,CEUS及增强MRI测得消融区体积测值差异无统计学意义(P>0.05),PMWA治疗后痛经和贫血等症状明显缓解。结论 CEUS可准确评价微波消融子宫腺肌病疗效,值得临床应用。
Objective To explore the effect and application value of Contrast Enhanced Ultrasound(CEUS) in treatment of Percutaneous Microwave Ablation(PMWA) for uterine adenomyosis. Methods 31 patients who were diagnosed as uterine adenomyosis by contrast-enhanced MRI voluntarily underwent PMWA. CEUS was performed before and after PMWA 1~2 d, contrast-enhanced MRI was also performed after the treatment. Analysis the accuracy of ablation range detected by CEUS after PMWA treatment. Results After PMWA treatment of 31 cases of uterine adenomyosis, CEUS showed that there was no contrast agent perfusion after ablation of uterine fibroids, and the ablation volume was(49.4+29.8) cm3. The volumes detected by CEUS and contrast-enhance MRI showed no significant statistical differences(P>0.05), the symptoms such as dysmenorrhea and anemia were obviously relieved after PMWA treatment. Conclusions CEUS can accurately evaluate the effect of microwave ablation uterine adenomyosis, which is worthy of clinical application.
Objective To explore the effect and application value of Contrast Enhanced Ultrasound(CEUS) in treatment of Percutaneous Microwave Ablation(PMWA) for uterine adenomyosis. Methods 31 patients who were diagnosed as uterine adenomyosis by contrast-enhanced MRI voluntarily underwent PMWA. CEUS was performed before and after PMWA 1~2 d, contrast-enhanced MRI was also performed after the treatment. Analysis the accuracy of ablation range detected by CEUS after PMWA treatment. Results After PMWA treatment of 31 cases of uterine adenomyosis, CEUS showed that there was no contrast agent perfusion after ablation of uterine fibroids, and the ablation volume was(49.4+29.8) cm3. The volumes detected by CEUS and contrast-enhance MRI showed no significant statistical differences(P>0.05), the symptoms such as dysmenorrhea and anemia were obviously relieved after PMWA treatment. Conclusions CEUS can accurately evaluate the effect of microwave ablation uterine adenomyosis, which is worthy of clinical application.
引文
[1]张晶,韩治宇,冯蕾,等.经皮穿刺微波消融治疗弥漫性子宫腺肌病[J].中华医学杂志,2011,91(39):2749-2752.
[2]张晶,冯蕾,张冰松,等.超声引导经皮子宫肌瘤微波消融后随访研究[J].中华医学杂志,2011,91(1):48-50.
[3]何光彬,周晓东,李秋洋,等.超声造影评价射频治疗子宫肌瘤的疗效及其应用价值[J].中华超声影像学杂志,2008,17(9):793-795.
[4]翟栋材,张申杰,张博,等.超声造影与增强MRI评价聚焦超声消融治疗子宫腺肌症的对照研究[J].山东大学学报(医学版),2014,52(S1):112-113.
[5]Champaneria R,Abedin P,Daniels J,et al.Ultrasound scanand magnetic resonance imaging for the diagnosis of adenomyosis:systematic review comparing test accuracy[J].Acta Obstet Gyn Sca,2010,89(11):1374-1384.
[6]Larroy C.Comparing visual-analog and numeric scales for assessing menstrual pain[J].Behav Med,2002,27(4):179-181.
[7]Khatri A,Kalra N.A comparison of two pain scales in the assessment of dental pain in East delhi children[J].Isrn Dent,2012,2012:247-351.
[8]王芳,张晶,韩治宇,等.超声造影在经皮微波消融子宫肌层良性病变围手术期中的作用[J/CD].中华医学超声杂志(电子版),2012,9(1):52-56.
[9]Wang F,Zhang J,Han ZY,et al.Imaging manifestation of conventional and contrast-enhanced ultrasonography in percutaneous microwave ablation for the treatment of uterine fibroids[J].Eur J Radiol,2012,81(11):2947-2952.
[10]Xia M,Jing Z,Zhi YH,et al.Feasibility study on energy prediction of microwave ablation upon uterine adenomyosis and leiomyomas by MRI[J].Brit J Radiol,2014,87(1040):20130770.
[11]Cockerham AZ.Adenomyosis:a challenge in clinical gynecology[J].J Midwifery Wom Heal,2012,57(3):212-220.
[12]Ferenczy A.Pathophysiology of adenomyosis[J].Hum Reprod Update,1998,4(4):312-322.
[13]Bergeron C,Amant F,Ferenczy A.Pathology and physiopathology of adenomyosis[J].Best Pract Res Cl Ob,2006,20(4):511-521.
[14]Lei F,Jing Z,Bo W,et al.Uterine myomas treated with microwave ablation:The agreement between ablation volumes obtained from contrast-enhanced sonography and enhanced MRI[J].Int J Hyperther,2014,30(1):11-18.
[15]张晶,关铮,钱林学,等.超声引导经皮微波消融治疗子宫腺肌病的临床应用方法及建议[J/CD].中华医学超声杂志(电子版),2016,13(2):96-100.
[16]Wylot B,Staszkiewicz J,Okrasa S.The expression of genes coding for opioid precursors,opioid receptors,beta-LH subunit and Gn RH receptor in the anterior pituitary of cyclic gilts[J].J Physiol Pharmacol,2008,59(4):745-758.
[17]Meden H,Fattahi-Meibodi A.CA125 in benign gynecological conditions[J].Int J Biol Markers,1998,13(4):231-237.
[2]张晶,冯蕾,张冰松,等.超声引导经皮子宫肌瘤微波消融后随访研究[J].中华医学杂志,2011,91(1):48-50.
[3]何光彬,周晓东,李秋洋,等.超声造影评价射频治疗子宫肌瘤的疗效及其应用价值[J].中华超声影像学杂志,2008,17(9):793-795.
[4]翟栋材,张申杰,张博,等.超声造影与增强MRI评价聚焦超声消融治疗子宫腺肌症的对照研究[J].山东大学学报(医学版),2014,52(S1):112-113.
[5]Champaneria R,Abedin P,Daniels J,et al.Ultrasound scanand magnetic resonance imaging for the diagnosis of adenomyosis:systematic review comparing test accuracy[J].Acta Obstet Gyn Sca,2010,89(11):1374-1384.
[6]Larroy C.Comparing visual-analog and numeric scales for assessing menstrual pain[J].Behav Med,2002,27(4):179-181.
[7]Khatri A,Kalra N.A comparison of two pain scales in the assessment of dental pain in East delhi children[J].Isrn Dent,2012,2012:247-351.
[8]王芳,张晶,韩治宇,等.超声造影在经皮微波消融子宫肌层良性病变围手术期中的作用[J/CD].中华医学超声杂志(电子版),2012,9(1):52-56.
[9]Wang F,Zhang J,Han ZY,et al.Imaging manifestation of conventional and contrast-enhanced ultrasonography in percutaneous microwave ablation for the treatment of uterine fibroids[J].Eur J Radiol,2012,81(11):2947-2952.
[10]Xia M,Jing Z,Zhi YH,et al.Feasibility study on energy prediction of microwave ablation upon uterine adenomyosis and leiomyomas by MRI[J].Brit J Radiol,2014,87(1040):20130770.
[11]Cockerham AZ.Adenomyosis:a challenge in clinical gynecology[J].J Midwifery Wom Heal,2012,57(3):212-220.
[12]Ferenczy A.Pathophysiology of adenomyosis[J].Hum Reprod Update,1998,4(4):312-322.
[13]Bergeron C,Amant F,Ferenczy A.Pathology and physiopathology of adenomyosis[J].Best Pract Res Cl Ob,2006,20(4):511-521.
[14]Lei F,Jing Z,Bo W,et al.Uterine myomas treated with microwave ablation:The agreement between ablation volumes obtained from contrast-enhanced sonography and enhanced MRI[J].Int J Hyperther,2014,30(1):11-18.
[15]张晶,关铮,钱林学,等.超声引导经皮微波消融治疗子宫腺肌病的临床应用方法及建议[J/CD].中华医学超声杂志(电子版),2016,13(2):96-100.
[16]Wylot B,Staszkiewicz J,Okrasa S.The expression of genes coding for opioid precursors,opioid receptors,beta-LH subunit and Gn RH receptor in the anterior pituitary of cyclic gilts[J].J Physiol Pharmacol,2008,59(4):745-758.
[17]Meden H,Fattahi-Meibodi A.CA125 in benign gynecological conditions[J].Int J Biol Markers,1998,13(4):231-237.