MR T2WI high signal rim sign affects immediate therapeutic responses of high intensity focused ultrasound ablation for uterine myoma / 中国介入影像与治疗学

ABSTRACT

Objective: To explore the impact of MR T2WI high signal rim sign (T2-rim sign) on the immediate efficacy of high intensity focused ultrasound (HIFU) in treatment of uterine myoma. Methods: Data of 360 uterine myoma patients treated with HIFU were retrospectively analyzed. The ablation effect was judged based on the percentage of non-perfusion area (NPV) of myoma after HIFU treatment and the volume of myoma before treatment (NPV%). According to the exist of preoperative MR T2-rim sign, the patients were divided into T2-rim sign group (with T2-rim sign) and no T2-rim sign group (without T2-rim sign). Univariate and multivariate Logistic analysis were performed to evaluate the impact of NPV%. Results: Immediately after ablation, contrast-enhanced ultrasound showed a marked reduction in blood supply of myoma, with 60 cases NPV%<75% and 300 cases NPV%≥75%, and significant differences of myoma location, irradiation time, treatment intensity, MR T2WI signal intensity and with or without T2-rim sign were found between them (all P<0.05). NPV% was correlated with MR T2WI signal intensity, T2-rim sign, irradiation time and treatment intensity (all P<0.05). The irradiation time, treatment intensity and T2-rim sign were independent risk factors for NPV% (all P<0.05). Compared with no T2-rim sign group, the irradiation time and treatment intensity of T2-rim sign group all increased (both P<0.05) and NPV% decreased (P<0.05). Conclusion: T2-rim sign is one of the impact factors of immediate therapeutic responses of HIFU ablation for uterine myoma. Uterine myoma patients with T2-rim sign are able benefit from HIFU.