超声消融子宫肌瘤后残余瘤组织的核磁共振影像学转归

Magnetic resonance imaging outcome of residual tumor after ultrasound ablation for uterine fibroids

    摘要
  • 摘要:
      目的   研究超声消融子宫肌瘤后残余瘤组织的核磁共振成像(MRI)转归。
      方法   对重庆医科大学附属第一医院74例子宫肌瘤患者(77个肌瘤)进行超声消融治疗。根据超声消融后1个月内所测体积消融率(消融率), 将74例患者分为三组。A组(24例): 消融率 > 90%;B组(28例): 消融率70%~90%;C组(22例): 消融率 < 70%。MRI监测三组治疗后1、3、6、12个月残余瘤组织的体积变化, 随访超声消融治疗后靶肌瘤的再治疗情况。
      结果   1) 治疗后1、3、6、12个月所测残余瘤组织平均体积, 消融率 > 90%组分别为(3.18±1.70)cm3、(1.88±0.99)cm3、(1.00±0.54)cm3、(0.44±0.20)cm3, 呈明显缩小趋势(P < 0.01)。消融率70%~90%组为(6.72±3.06)cm3、(7.41±4.67)cm3、(5.19±3.91)cm3、(4.75±3.17)cm3, 呈现缩小趋势(P < 0.05)。消融率 < 70%组为(17.95±8.85)cm3, (22.10±13.30)cm3、(23.31±13.37)cm3、(23.93±12.85)cm3, 体积变化差异无显著性统计学意义(P > 0.05)。2)治疗后12个月再次治疗情况: 消融率 > 90%者, 无一例在治疗后12个月内需要再次干预治疗, 消融率70%~90%者及消融率 < 70%者分别有10.7%及54.5%患者在治疗后12个月内再次行超声消融或手术治疗。
      结论   超声消融率≥70%组的残余瘤组织的体积在术后12个月内呈明显缩小转归趋势, 并且治疗后靶肌瘤的再干预情况明显少于消融率 < 70%组。消融的体积越大, 再治疗的机会越小。

     

    Abstract:
      Objective   This study aimed to determine the outcome of the residual tissue measured by magnetic resonance imaging(MRI) after ultrasound ablation for uterine fibroids.
      Methods   A total of 77 patients with uterine fibroids subjected to high-intensity focused ultrasound ablation were enrolled in this study undertaken in the First Affiliated Hospital of the Chongqing Medical University.The patients were grouped into three based on the different non-perfused volume(NPV) rates measured by MRI within 1 month after ultrasound ablation.Group A comprised 24 patients whose NPV ratios were more than 90%.Group B comprised 28 patients whose NPV ratios were from 70% to 90%.Group C comprised 22 patients whose NPV ratios were less than 70%.MRI was used to monitor the change in residual tumor volume of the three groups 1, 3, 6, and 12 months after treatment.All re-treated cases were recorded.
      Results   The mean residual tumor volumes of group A were 3.18 ± 1.70, 1.88 ± 0.99, 1.00 ± 0.54, 0.44 ± 0.20 cm3at 1, 3, 6, and 12 months after treatment, respectively.These results indicated a significant decrease with time(P < 0.01).The mean residual tumor volumes of group B were 6.72 ± 3.06, 7.41 ± 4.67, 5.19 ± 3.91, 4.75 ± 3.17 cm3 at 1, 3, 6, and 12 months after treatment, respectively.These results indicated a decrease with time(P < 0.05).The mean residual tumor volumes of group C were 17.95 ± 8.85, 22.10 ± 13.30, 23.31 ± 13.37, 23.93 ± 12.85 cm3 at 1, 3, 6, and 12 months after treatment, respectively.No significant change was found(P > 0.05).No case in group A required re-intervention.The re-intervention rates in groups B and C were 10.7% and 54.5%, respectively, within 12 months after treatment.
      Conclusion   In cases where the ablation rate was equal to or more than 70%, the volume of residual tumor significantly decreased within 12 months after treatment, and the re-intervention rate was less than cases of less than 70%.Fewer incidences of re-treatment resulted in a higher ablation rates.

     

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