【摘要】：目的： 探討低場(chǎng)強(qiáng)MRI對(duì)超聲引導(dǎo)下經(jīng)皮穿刺微波消融（MWA）子宮肌瘤療效的評(píng)價(jià)。 方法： 128例154個(gè)子宮肌瘤行超聲引導(dǎo)下經(jīng)皮穿刺微波消融。分別于治療前1天，治療后3天行磁共振（MRI）增強(qiáng)掃描，總結(jié)子宮肌瘤微波治療前后的MRI特征，分析治療前后MRI信號(hào)強(qiáng)度變化。 結(jié)果： 微波治療后與治療前比較，治療前病灶內(nèi)強(qiáng)化程度明顯減輕，病灶大小無明顯變化。微波消融治療后的子宮肌瘤MRI特征性信號(hào)改變與機(jī)載的超聲造影顯像變化比較，無統(tǒng)計(jì)學(xué)顯著性差異（P0.05）。MRI T2WI信號(hào)為低、等、高、混染信號(hào)的子宮肌瘤體積消融率分別為(86.03±11.44)%、(70.43±14.54)%、(64.33±17.51)%、(71.54±19.32)%。MRI T2WI呈高信號(hào)的子宮肌瘤體積消融率明顯低于低信號(hào)的肌瘤，，有統(tǒng)計(jì)學(xué)顯著性差異(P0.05)。MRI T1WI增強(qiáng)信號(hào)呈低信號(hào)、等信號(hào)、高信號(hào)的子宮肌瘤體積消融率分別為(83.30±16.72)%、(75.83±17.21)%。、(67.32±15.63)%。MRI增強(qiáng)掃描T1信號(hào)強(qiáng)度越高，微波消融體積消融率越低，不同血供的肌瘤消融療效有統(tǒng)計(jì)學(xué)顯著性差異(P0.05)。術(shù)中、術(shù)后并發(fā)癥中出現(xiàn)下腹部疼痛103例，占66.89%；骶尾部、臀部疼痛82例，占53.25%；術(shù)區(qū)皮膚損傷3例，占1.95%；陰道淡血性分泌物24例，占15.58%；下肢疼痛、麻木8例，占5.20%；低熱53例，占34.42%。 結(jié)論： MRI平掃及增強(qiáng)掃描對(duì)超聲引導(dǎo)下經(jīng)皮穿刺微波消融子宮肌瘤具有十分重要的評(píng)估價(jià)值，MRI平掃及增強(qiáng)掃描病變信號(hào)強(qiáng)度變化對(duì)微波治療效果具有重要參考價(jià)值。
[Abstract]:Objective: to evaluate the effect of low field MRI on ultrasound guided percutaneous microwave ablation of (MWA) uterine leiomyoma. Methods: ultrasound guided percutaneous microwave ablation of 154 uterine leiomyomas was performed in 128 cases. Mr (MRI) enhanced scanning was performed 1 day before and 3 days after treatment to summarize the characteristics of MRI before and after microwave treatment of uterine leiomyoma and to analyze the changes of MRI signal intensity before and after treatment. Results: after microwave treatment, the enhancement degree of the lesion was obviously reduced and the size of the lesion was not changed. There was no significant difference between the changes of MRI characteristic signal of uterine leiomyoma after microwave ablation and that of airborne ultrasound imaging (P0.05). The ablation rate of uterine myoma volume with mixed signal was (86.03 鹵11.44), (70.43 鹵14.54), (64.33 鹵17.51), (71.54 鹵19.32). The ablation rate of myoma volume with high signal intensity was significantly lower than that of hysteromyoma with low signal intensity (P0.05). The volume ablation rate of hysteromyoma with high signal intensity was (83.30 鹵16.72), (75.83 鹵17.21) and (67.32 鹵15.63), respectively. Intraoperative complications included lower abdominal pain in 103 cases (66.89%), sacrococcygeal and hip pain in 82 cases (53.2535), skin injury in 3 cases (1.95%), vaginal discharge in 24 cases (15.58), lower limb pain and numbness in 8 cases (5.20%). There were 53 cases of low fever, accounting for 34.42%. Conclusion: MRI plain scan and enhanced scan are very important for ultrasound guided percutaneous microwave ablation of uterine leiomyoma.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.33;R445.2

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