摘要
目的:探讨实时超声弹性成像(Real-time ultrasound elastography,RTE)在子宫肌瘤射频消融治疗(radiofrequency ablation,RFA)中的应用价值。方法:对34例行RFA治疗的子宫肌瘤患者(共38个病灶)于术前、术后1小时、术后3个月进行阴式超声、RTE及超声造影(contrast-enhanced ultrasonography,CEUS)检查。在2D、RTE、CEUS三种条件下分别测量病灶的直径。分析术前弹性图特征并分组,测量病灶弹性应变比率(E/E_0),对比分析组间、组内的E/E_0。比较2D、RTE、CEUS条件下病灶直径之间的差异。术后以弹性图像上病灶显示蓝绿相间为判定消融不全的标准,与CEUS对比,分析RTE与CEUS对消融程度评估的一致性。结果:根据术前肌瘤弹性图像将病灶分为蓝色组8个(21.1%),蓝色为主组20个(52.6%),绿色为主组10个(26.3%),术前3组病灶之间E/E_0差异明显,术后1小时、术后3个月E/E_0差异无统计学意义(P>0.05),组内RFA术后1小时、3个月病灶E/E_0较术前明显增大,术后3个月E/E_0大于术后1小时(P<0.05);术前RTE检测病灶直径大于2D及CEUS(P<0.05),术后1小时2D测量直径大于RTE及CEUS(P<0.05),三种成像技术在术后3个月测量病灶直径差异无统计学意义(P>0.05);RFA术后1小时及术后3个月RTE对病灶消融程度评估结果与CEUS基本一致,Kappa值分别为0.46、0.54。结论:RFA术后肌瘤逐步变硬,RTE检查能够反映这种硬度变化,并且能够评估消融病灶的范围并预估消融程度,因此RTE在子宫肌瘤RFA治疗中有一定的应用价值。
Objective：To investigate the application value of real-time ultrasound elastography in the treatment of fibroids radiofrequency ablation （RFA）.Methods：Transvaginal ultrasonography,Real-time ultrasound elastography （RTE） and contrast-enhanced ultrasonography （CEUS） were performed on 34 patients with a total of 38 uterine fibroids who had the treatment of RFA before,1 hour and 3 months after the treatment of RFA.Detected the diameters of the lesions with the three methods of CEUS,RTE and 2D.Analysed the elastic image features and divided into groups,Measured the elastic strain ratio and compared the E/E0 in and between the group.The difference of lesion diameter between 2D,RTE and CEUS was compared.When the image of lesions showed blue and green was taken as the cirterion of incomplete ablation after RFA,conpared with CEUS,analysed the consistency of RTE and CEUS in evaluating the degree of ablation.Results：The lesions were divided into 3 groups according to the preoperative elastic image,with 8 （21.1%） in the blue group,20 （52.6%） in blue-based and 10 （26.3%） in green-based group.The difference was obvious in E/E0 between the 3 groups before RFA.There was no significant difference in E/E0 between 1 hour and 3 months after RFA （P 〉 0.05）.In each group the E/E0 of lesions were significantly increased at 1 hour and 3 months after the treatment of FRA,and the hardness of 3 months after RFA was harder than that of 1 hour after RFA（P〈0.05）.The diameter measured by RTE was larger than that by 2D and CEUS before RFA（P〉0.05）.The diameter measured by 2D was larger than that by RTE and CEUS at 1 hour after RFA （P〈0.05）.No statistically significant difference was found in the lesion diameters among the three methods of2D,RTE and CEUS at 3 months after the treatment ofRFA （P〉0.05）.CEUS and RTE had the basic consistent in the evaluation of lesions ablation degree at 1 hour （kappa=0.46） and 3 months （kappa=0.54） after the treatment of RFA.Conclusions：After RFA,the myoma gradually hardens,and RTE can reflect the change of the hardness,RTE can clearly show the boundary of uterine ftbroids especially after the treatment of RFA,can be used in the prediction of lesions ablation degree,so there was a certain application value of RTE used in RFA.
出处
《现代生物医学进展》
CAS
2017年第25期4967-4970,4966,共5页
Progress in Modern Biomedicine
基金
国家自然科学基金项目(81271646)
关键词
子宫肌瘤
射频治疗
弹性成像
Uterine fibroids
Radiofrequency ablation
Real-time ultrasound elastography
