术前磁共振成像联合多模态超声在微波消融术治疗育龄期症状性局灶性子宫腺肌病中的价值OA
Clinical Significance of Preoperative Magnetic Resonance Imaging Combined with Multimodal Ultrasound Assessment in Microwave Ablation Treatment of Symptomatic Focal Adenomyosis in Reproductive-Aged Women
目的:探讨磁共振成像(MRI)联合多模态超声在超声引导下经皮微波消融术(PMWA)治疗育龄期症状性局灶性子宫腺肌病(AM)中的术前应用价值.方法:选择 2021 年 9 月 1 日至 2024年3 月31 日于安徽医科大学第二附属医院接受 PMWA 治疗的育龄期症状性局灶性 AM 患者95 例为研究对象,随机方法分为两组,联合组(51 例):术前采用经腹部超声检查(TAUS)+经阴道超声检查(TVS)+超声对比增强造影(CEUS)+动态增强 MRI(DCE-MRI)联合评估;对照组(44 例):术前仅采用超声(TAUS+TVS+CEUS)检查评估.比较两组术后病灶即刻消融率和不良反应[国际介入放射协会(SIR)并发症分级]),以及术前及术后1、3、6、12 月子宫体积减小率(UCR)、AM 病灶体积减小率(ALR)、视觉模拟量表(VAS)、症状严重程度(SSS)评分、健康相关的生活质量量表(HRQL)评分变化.结果:两组患者 PMWA 术后即刻消融率均≥90%,不良反应均为 SIR A/B 级,两组差异无统计学意义(P>0.05).术后12 月随访中:联合组在6、12 月时的 UCR 和 ALR 显著优于对照组(P<0.05);联合组的 SSS 评分在 6、12 月时和 HRQL 评分在 12 月时的改善比对照组更显著(P<0.05);两组的痛经 VAS 评分改善间差异无统计学意义(P>0.05);联合组临床疗效满意率高于对照组(86.3%vs.77.3%,P=0.254).结论:PMWA 治疗症状性局灶性AM 疗效显著,术前MRI 联合多模态超声评估 AM 病灶在 PMWA 治疗育龄期症状性局灶性 AM 中具有显著临床价值.
Objective:The preoperative application value of magnetic resonance imaging(MRI)combined with multimodal ultrasound in ultrasound-guided percutaneous microwave ablation(PMWA)for fertile-age women with symptomatic focal adenomyosis(AM).Methods:This study enrolled 95 fertile-age women with symptomatic focal adenomyosis who underwent PMWA at the Second Affiliated Hospital of Anhui Medical University between Sep-tember 1,2021,and March 31,2024.Patients were randomly allocated into two groups.The combined group(n=51)received a comprehensive preoperative assessment via transabdominal ultrasound(TAUS),transvaginal sonography(TVS),contrast-enhanced ultrasound(CEUS),and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI).The control group(n=44)underwent preoperative evaluation with ultrasound only(TAUS+TVS+CEUS).The immediate postoperative ablation rate and adverse reactions(SIR complication classification)were compared between the two groups.Additionally,changes in the uterine corpus volume reduction rate(UCR),adenomyosis lesion volume reduction rate(ALR),visual analog scale(VAS)score,symptom severity score(SSS),and health-related quality of life(HRQL)score were compared preoperatively and at 1,3,6,and 12 months postoperatively.Results:The immediate post-PMWA ablation rates in both groups were≥90%,with all adverse reactions graded as SIR class A/B,showing no statistically significant intergroup difference(P>0.05).During the 12-month follow-up:the combined group demonstrated significantly better UCR and ALR at 6 and 12 months compared to the control group(P<0.05);the improvements in SSS at 6 and 12 months and in HRQL at 12 months were more significant in the combined group than in the control group(P<0.05);there was no statisti-cally significant difference in VAS improvement between the two groups(P>0.05);the clinical efficacy satisfaction rate was markedly higher in the combined group(86.3%vs.77.3%,P=0.254).Conclusions:PMWA is an effec-tive treatment for focal adenomyosis.Preoperative assessment with a combination of MRI and multimodal ultra-sound demonstrates significant clinical value in managing fertile-age women with symptomatic focal adenomyosis undergoing PMWA.
许诺;李凡;陈智;吴军;蓝晓锋;解翔
安徽医科大学第二附属医院超声医学科,安徽 合肥 230601安徽医科大学第二附属医院超声医学科,安徽 合肥 230601安徽医科大学第二附属医院超声医学科,安徽 合肥 230601安徽医科大学第二附属医院超声医学科,安徽 合肥 230601安徽医科大学第二附属医院超声医学科,安徽 合肥 230601安徽医科大学第二附属医院超声医学科,安徽 合肥 230601
医药卫生
子宫腺肌病微波消融术动态增强磁共振成像超声对比增强造影经阴道超声
AdenomyosisPercutaneous microwave ablationDynamic contrast-enhanced magnetic reso-nance imagingContrast-enhanced ultrasoundTransvaginal sonography
《实用妇产科杂志》 2026 (5)
405-411,7
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