超声对HIFU治疗子宫肌瘤疗效的价值研究
摘要
目的探讨超声对高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗子宫肌瘤疗效的价值。方法回顾性分析我院2016年1月至2017年1月收治的经HIFU治疗的子宫肌瘤76例患者的彩色多普勒超声临床资料,在多普勒超声的监测下,行HIFU治疗子宫肌瘤,观察治疗前后患者瘤体的大小、血流动力学、内部回声的改变以评价其疗效。结果术后患者瘤体体积以及瘤体体积缩小率减小显著,差异有统计学意义(P<0.05),但是术后1月和6月瘤体体积以及缩小率变化差异不显著;根据患者二维声像图显示,治疗后随着时间的延长,其回声逐渐增强并出现小团状强回声或局部液化暗区,血流信号逐渐减弱至消失;术后患者的治疗有效率为89.47%。结论彩色多普勒超声可以测量子宫肌瘤HIFU术后瘤体体积、观察其回声强度及血流动力学的变化,从而有效地判断其疗效,具有较高的临床使用价值,值得推广使用。
引文
[1] Uzoma O I.Uterine fibroids:Repeat myomectomy converted to supracervical hysterectomy.A case report and literature review[J].Drugs,2015,42(4):690-719.
[2] Annefleur M,Ankum,Willem M,et al.Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids,10 years’ outcomes from the randomized EMMY trial[J].American Journal of Obstetrics & Gynecology,2016,196(6):1-11.
[3] 张向阳,潘晶晶,靳志涛,等.低场MRI评估高强度聚焦超声对子宫肌瘤治疗价值的研究[J].中国医疗设备,2014,29(6):164-166.
[4] Sun R,Ultrasound D O.Analysis of the value of color doppler ultrasound diagnosis of uterine fibroids and contrast adenomyosis[J].China Modern Doctor,2014.,52(12):77-78+161.
[5] 吴曙军,陈迎祯,伏钢,等.高强度聚焦超声消融子宫肌瘤供血动脉的治疗价值[J].中华超声影像学杂志,2014,23(6).516-519.
[6] 卢瑞沾,张俊成,杨振华,等.IVIM-DWI评价高强度聚焦超声治疗子宫肌瘤早期疗效的价值[J].临床放射学杂志,2017,36(5):692-696.
[7] 王伟,张暹东,李祎,等.动态增强磁共振成像定量参数对子宫肌瘤高强度聚焦超声治疗效果的即时评估价值初探[J].磁共振成像,2015(8):603-607.
[8] 马婉玲,赵萌,曾铭.增强 MRI 在高强度聚焦超声治疗子宫肌瘤疗效的评估价值[J].江苏医药,2016,42(23):2569-2572.
[9] Stepp K J,Newman J S,Bradley L D.Uterine artery embolization for the treatment of uterine fibroids[J].Curr Opin Obstet Gynecol,2015,10(4):315-320.
[10] Biglia N,Carinelli S,Maiorana A,et al.Ulipristal acetate:a novel pharmacological approach for the treatment of uterine fibroids[J].Drug Design Development & Therapy,2014,8:285.
[11] Bohlmann M K,Hoellen F,Hunold P,et al.High-intensity focused ultrasound ablation of uterine fibroids-potential impact on fertility and pregnancy outcome[J].Geburtshilfe Und Frauenheilkunde,2014,74(2):139.
[12] Kim Y S,Bae D S,Park M J,et al.Techniques to expand patient selection for MRI-guided high-intensity focused ultrasound ablation of uterine fibroids[J].Ajr American Journal of Roentgenology,2014,202(2):443.
[13] Hasan M,Nasir A,Saba E.Color doppler misoprostol response study(CDMRS):an evaluation tool for patients awaiting myomectomy[J].Journal of Medical Ultrasound,2014,22(2):78-82.
[14] Wu C C,Lee C N,Chen T M,et al.Incremental angiogenesis assessed by color Doppler ultrasound in the tumorigenesis of ovarian neoplasms[J].Cancer,2015,73(4):1251-1256.
[15] 王智亮,熊正爱,陈骊,等.高强度聚焦超声消融治疗围绝经期子宫肌瘤的初步研究[J].中国超声医学杂志,2014,30(1):55-58.
[16] Mahmoud M Z,Alkhorayef M,Alzimami K S,et al.High-intensity focused ultrasound(HIFU)in uterine fibroid treatment:review study[J].Polish Journal of Radiology,2014,79(1):384.
[2] Annefleur M,Ankum,Willem M,et al.Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids,10 years’ outcomes from the randomized EMMY trial[J].American Journal of Obstetrics & Gynecology,2016,196(6):1-11.
[3] 张向阳,潘晶晶,靳志涛,等.低场MRI评估高强度聚焦超声对子宫肌瘤治疗价值的研究[J].中国医疗设备,2014,29(6):164-166.
[4] Sun R,Ultrasound D O.Analysis of the value of color doppler ultrasound diagnosis of uterine fibroids and contrast adenomyosis[J].China Modern Doctor,2014.,52(12):77-78+161.
[5] 吴曙军,陈迎祯,伏钢,等.高强度聚焦超声消融子宫肌瘤供血动脉的治疗价值[J].中华超声影像学杂志,2014,23(6).516-519.
[6] 卢瑞沾,张俊成,杨振华,等.IVIM-DWI评价高强度聚焦超声治疗子宫肌瘤早期疗效的价值[J].临床放射学杂志,2017,36(5):692-696.
[7] 王伟,张暹东,李祎,等.动态增强磁共振成像定量参数对子宫肌瘤高强度聚焦超声治疗效果的即时评估价值初探[J].磁共振成像,2015(8):603-607.
[8] 马婉玲,赵萌,曾铭.增强 MRI 在高强度聚焦超声治疗子宫肌瘤疗效的评估价值[J].江苏医药,2016,42(23):2569-2572.
[9] Stepp K J,Newman J S,Bradley L D.Uterine artery embolization for the treatment of uterine fibroids[J].Curr Opin Obstet Gynecol,2015,10(4):315-320.
[10] Biglia N,Carinelli S,Maiorana A,et al.Ulipristal acetate:a novel pharmacological approach for the treatment of uterine fibroids[J].Drug Design Development & Therapy,2014,8:285.
[11] Bohlmann M K,Hoellen F,Hunold P,et al.High-intensity focused ultrasound ablation of uterine fibroids-potential impact on fertility and pregnancy outcome[J].Geburtshilfe Und Frauenheilkunde,2014,74(2):139.
[12] Kim Y S,Bae D S,Park M J,et al.Techniques to expand patient selection for MRI-guided high-intensity focused ultrasound ablation of uterine fibroids[J].Ajr American Journal of Roentgenology,2014,202(2):443.
[13] Hasan M,Nasir A,Saba E.Color doppler misoprostol response study(CDMRS):an evaluation tool for patients awaiting myomectomy[J].Journal of Medical Ultrasound,2014,22(2):78-82.
[14] Wu C C,Lee C N,Chen T M,et al.Incremental angiogenesis assessed by color Doppler ultrasound in the tumorigenesis of ovarian neoplasms[J].Cancer,2015,73(4):1251-1256.
[15] 王智亮,熊正爱,陈骊,等.高强度聚焦超声消融治疗围绝经期子宫肌瘤的初步研究[J].中国超声医学杂志,2014,30(1):55-58.
[16] Mahmoud M Z,Alkhorayef M,Alzimami K S,et al.High-intensity focused ultrasound(HIFU)in uterine fibroid treatment:review study[J].Polish Journal of Radiology,2014,79(1):384.