RESUMO
Objective To investigate the clinical utility of SonoVue,a microbubble-enhancing contrast agent,in the treatment of uterine fibroids carrying different signal intensities on T2WI with high-intensity focused ultrasound (HIFU).Methods Based on the preoperative MRI signal intensity on T2WI,a total of 64 patients with uterine fibroids,who were scheduled to receive HIFU,were divided into low-intensity group (n =24),iso-intensity group (n =22) and high-intensity group (n =18).MRI check-up examination was performed one day after HIFU treatment to evaluate the ablation effect.The parameters related to HIFU,including therapeutic power,irradiation time and therapeutic dose,and the indexes related to therapeutic effect,including volume ablation rate (non-perfusion volume ratio,NPVR),energy-efficiency factor,treatment time,were recorded,and the results were compared between each other among the three groups.Results In the low-intensity group,iso-intensity group and high-intensity group,the volume ablation rates were (84.83±18.49)％,(8.72±17.76)％ and (71.11±23.87)％ respectively,the energy-efficiency factors were (6.87±7.77) J/mm3 (7.99±6.58) J/mm3 and (12.93±9.38) J/mm3 respectively,the treatment time were (102.12±54.45) min,(153.86±66.04) min and (141.50±69.56) min respectively.Single factor analysis indicated that statistically significant differences in volume ablation rate,energy-efficiency factor and treatment time existed between each other among the three groups.Among the total 64 patients,3 patients developed lower abdominal pain (6/64,9.4％),3 patients complained of general aches with numb (3/64,4.7％),and no severe complications,such as skin burn in treatment area,etc.,occurred in all patients.Conclusion The curative effect of SonoVue combined with HIFU for low-intensity and iso-intensity uterine fibroids is better than that for high-intensity uterine fibroids;the treatment time for low-intensity uterine fibroids is shorter than that for iso-intensity and high-intensity uterine fibroids.SonoVue is a safe and effective synergist for HIFU treatment.
RESUMO
Objective To investigate the value of parametric imaging of CEUS in uterine fibroids with different signal intensity on T2WI by high intensity focused ultrasound (HIFU),and dynamic vascular pattern (DVP).Methods Totally 16 patients with single uterine fibroids were divided into high intensity group (n=6),isointensity group (n=4) and low intensity group (n=6) according the signal intensity on T2WI before HIFU treatment.CEUS were performed on each patient.SonoLive CAP software was used to analyze the CEUS images and DVP parametric images were reconstructed.Results The maximum intensity,rising time,time to peak and mean transit time were (235.40± 35.46)％,(22.80± 3.16)s,(25.09±2.44)s,(125.78 ± 27.63)s in high intensity group,(71.97± 2.43) ％,(24.85±3.22)s,(32.81±3.92)s,(66.52±3.48)s in isointensity group and (16.17±2.83) ％,(25.42±2.66)s,(32.82±3.76)s,(64.27±3.33)s in low intensity group.There were statistically significant differences among three groups (all P＜0.05).DVP curve was divided into two types:non-washout in high intensity group and cystic type in low intensity group.Conclusion CEUS and DVP imaging can directly quantitively display the difference of blood perfusion among the uterine fibroids with different signal intensity on T2WI which can provide important information for HIFU treatment in uterine fibroids.