多序列MRI评估高强度聚焦超声治疗子宫肌瘤、腺肌症及剖宫产瘢痕妊娠的疗效与安全性OA
Efficacy and safety of high-intensity focused ultrasound in the treatment of uterine fibroids,adenomyosis and cesarean scar pregnancy using multi-sequence MRI evaluation
目的 探讨多序列MRI评估高强度聚焦超声(HIFU)治疗子宫肌瘤、子宫腺肌症及剖宫产瘢痕妊娠的效果与安全性.方法 选取接受HIFU治疗的120例患者为研究对象,依据疾病类型分为子宫肌瘤组(40例)、子宫腺肌症组(40例)和瘢痕妊娠组(40例).瘢痕妊娠组中,部分患者因病灶血供丰富或血人绒毛膜促性腺激素β亚单位(β-HCG)水平较高,联合子宫动脉栓塞术(UAE)或甲氨蝶呤(MTX)治疗.所有患者均在治疗前1周内及治疗后3个月行多序列MRI(T1WI、T2WI、DWI、动态增强MRI)检查.通过标准化评估体系比较3组患者治疗前后病灶体积、MRI信号特征变化.同时,统计患者治疗后24 h、1周、3个月的不良反应发生率,综合评估HIFU治疗的效果与安全性.结果 治疗后3个月,3组患者病灶体积均较治疗前缩小,差异有统计学意义(P＜0.05).多序列MRI显示,3组患者治疗后病灶T2WI高信号占比、DWI高信号占比及动态增强MRI强化率均较治疗前降低,差异有统计学意义(P＜0.05).患者治疗后24 h、1周、3个月的不良反应呈逐步下降趋势,组间比较差异无统计学意义(P＞0.05).结论 HIFU治疗子宫肌瘤、子宫腺肌症及瘢痕妊娠均具有良好的安全性和有效性,多序列MRI可通过量化病灶体积、分析信号特征及血供变化,为3种疾病的HIFU疗效与安全性评估提供影像学依据.
Objective To investigate the efficacy and safety of multi-sequence MRI in evaluating high-intensity focused ultrasound(HIFU)treatment for uterine fibroids,adenomyosis,and cesarean scar pregnancy.Methods A total of 120 patients who underwent HIFU treatment were selected as the study subjects and divided into three groups based on disease type:uterine fibroid group(40 ca-ses),adenomyosis group(40 cases)and cesarean scar pregnancy group(40 cases).In the cesarean scar pregnancy group,some patients received combined treatment with uterine artery embolization(UAE)or methotrexate(MTX)due to richblood supply to the lesion or elevated levels of beta-human chorionic gonadotropin(β-HCG).All patients underwent multi-sequence MRI(T1WI,T2WI,DWI and dynamic contrast-enhanced MRI)within 1 week before treatment and 3 months after treatment.Changes in lesion volume and MRI signal characteristics before and after treatment were compared a-mong the three groups using a standardized evaluation system.Additionally,the incidence of adverse reactions at 24 hours,1 week and 3 months after treatment was statistically analyzed to comprehen-sively evaluate the efficacy and safety of HIFU treatment.Results At 3 months after treatment,the lesion volumes in three groups were significantly reduced compared to those before treatment(P＜0.05).Multi-sequence MRI revealed that the proportions of high T2WI signal,high DWI signal and dynamic contrast-enhanced MRI enhancement rate in the lesions of three groups were significantly decreased after treatment compared to those before treatment(P＜0.05).The incidence of adverse reactions at 24 hours,1 week and 3 months after treatment showed a gradual declining trend,with no statistically significant differences among the groups(P＞0.05).Conclusion HIFU treatment demonstrates favorable safety and efficacy in the management of uterine fibroids,adenomyosis and cesarean scar pregnancy.Multi-sequence MRI can provide imaging evidence for evaluating the effi-cacy and safety of HIFU treatment for these three diseases by quantifying lesion volume,analyzing signal characteristics,and assessing changes in blood supply.
王军委;孙喆
郑州市金水区总医院医学影像科,河南郑州,450003郑州市金水区总医院医学影像科,河南郑州,450003
医药卫生
高强度聚焦超声消融术磁共振成像子宫肌瘤子宫腺肌症剖宫产瘢痕妊娠疗效安全性不良反应
high-intensity focused ultrasound ablationmagnetic resonance imaginguterine fi-broidsadenomyosiscesarean scar pregnancyefficacysafetyadverse reactions
《实用临床医药杂志》 2026 (8)
15-20,28,7
国家自然科学基金资助项目(82315072)河南省医学科技攻关计划项目(LHGJ20240970)
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