MRI评价子宫肌瘤高强度聚焦超声消融术后盆底筋膜改变

摘要

目的 探讨MRI评价子宫肌瘤高强度聚焦超声消融术(HIFU)后盆底筋膜改变的价值.方法 回顾性分析初次行HIFU治疗的283例子宫肌瘤患者的盆腔MRI及临床资料,观察盆腔筋膜水肿情况,记录HIFU治疗总能量、辐照时间.分析患者年龄、肌瘤情况(位置、类型、数量、体积)及HIFU治疗总能量、辐照时间与盆底筋膜改变的相关性.结果 共201例(201/283,71.02％)患者HIFU后盆腔筋膜出现水肿,59.71％(169/283)为1度和2度.不同肌瘤位置患者术后盆底筋膜水肿程度差异有统计学意义(x2=27.50,P=0.007).患者年龄、肌瘤情况(数目、体积)与盆腔筋膜水肿程度无相关性(P均＞0.05);HIFU治疗总能量、辐照时间与盆腔筋膜水肿程度呈正相关(rs=0.288、0.317,P均＜0.001).结论 采用MRI可评价HIFU治疗子宫肌瘤引起的盆腔筋膜水肿,HIFU辐照时间、治疗总能量、子宫肌瘤位置是引起盆底筋膜水肿的主要影响因素.%Objective To explore the value of pelvic fascia changes after high intensity focused ultrasound (HIFU) ablation of uterine fibroids patients with MRI.Methods The pelvic MRI and clinical data of 283 patients with uterine fibroids after treatment of HIFU were analyzed retrospectively.The total power and irradiation time of HIFU,and the degree of pelvic fascia edema changes were observed.The correlation between age,fibroids location,type,number,volume,total energy,irradiation time of HIFU and the degree of pelvic fascia edema were analyzed.Results Totally 201 patients (201/283,71.02％) had pelvic fascia edema and 59.71％ (169/283) were degree 1 and 2.There was significant difference in the degree of pelvic fascia edema in patients with different fibroids (x2 =27.50,P=0.007).There was no correlation between patients age,number,volume,type of fibroids,nor pelvic fascia edema (all P＞0.05).HIFU energy and irradiation time were positively correlated with the degree of pelvic fascia edema (rs =0.288,0.317,both P＜0.001).Conclusion MRI can observe pelvic fascia edema caused by HIFU treatment of uterine fibroids.HIFU irradiation time,total energy,and location of uterine fibroids location are the main influencing factors.