影響超聲消融子宮腺肌病療效相關(guān)因素研究
發(fā)布時(shí)間：2018-08-08 17:48
【摘要】：高強(qiáng)度聚焦超聲(High intensity focused ultrasound,HIFU)消融是近年新發(fā)展起來(lái)的一項(xiàng)非侵入性治療技術(shù)。由于其創(chuàng)傷小、恢復(fù)快、療效確切、可保留子宮等特點(diǎn),在治療子宮腺肌病的臨床應(yīng)用上日益廣泛。HIFU消融治療子宮腺肌病的原理是將體外低能量的超聲波聚焦于腺肌病灶內(nèi),通過(guò)焦點(diǎn)處超聲波產(chǎn)生的熱能量使病灶發(fā)生不可逆性凝固性壞死,從而使異位的子宮內(nèi)膜失去生長(zhǎng)和出血功能,達(dá)到治療目的同時(shí)而又不損傷靶區(qū)周圍組織。隨著臨床研究的不斷深入,在臨床應(yīng)用過(guò)程中發(fā)現(xiàn),不同腺肌病灶對(duì)HIFU消融治療的反應(yīng)不一致,部分患者容易取得良好的消融率,也有部分患者消融效果欠佳,但其相關(guān)影響因素尚未明確。本文旨在通過(guò)大樣本研究,從消融率、能效因子(EEF)、團(tuán)塊狀強(qiáng)回聲三個(gè)消融療效指標(biāo)綜合分析影響超聲消融子宮腺肌病療效的因素。為HIFU治療子宮腺肌病優(yōu)化適應(yīng)癥、優(yōu)化治療方案提供依據(jù)。目的探討影響HIFU治療子宮腺肌病療效的相關(guān)因素。材料和方法回顧性分析2011年1月至2014年7月重慶市海扶醫(yī)院接受HIFU治療的245例子宮腺肌病患者,所有患者在HIFU治療前后均進(jìn)行MRI增強(qiáng)掃描。分別將消融率、EEF及團(tuán)塊狀強(qiáng)回聲設(shè)定為因變量,可能影響消融療效的因素設(shè)定為自變量建立多元回歸模型。結(jié)果245例子宮腺肌病患者均一次性完成HIFU消融治療。T1WI強(qiáng)化類型、腹壁厚度、腺肌病灶體積、高信號(hào)出血點(diǎn)數(shù)量、子宮位置、腺肌病灶位置與消融率存在線性相關(guān)性。病灶腹側(cè)面到皮膚的距離、T1WI強(qiáng)化類型、腺肌病灶體積、腹壁厚度及T2WI信號(hào)強(qiáng)度與EEF存在線性相關(guān)性。子宮位置和腹壁厚度與團(tuán)塊狀強(qiáng)回聲的出現(xiàn)存在線性關(guān)系。結(jié)論T1WI強(qiáng)化類型、T2WI信號(hào)強(qiáng)度、腺肌病灶體積、子宮位置、腺肌病灶位置、高信號(hào)出血點(diǎn)數(shù)量、腹壁厚度、病灶腹側(cè)面到皮膚的距離均可作為預(yù)測(cè)HIFU消融子宮腺肌病療效的因素。
[Abstract]:High intensity focused ultrasound (High intensity focused) ablation is a newly developed noninvasive therapy technique. Because of its small trauma, quick recovery, accurate curative effect and so on, it can preserve the uterus and so on. The principle of HIFU ablation in the treatment of adenomyosis is to focus the low energy ultrasound on the adenomyosis in vitro. The thermal energy generated by ultrasonic at the focal point causes irreversible coagulation necrosis of the lesion, which causes ectopic endometrium to lose its function of growth and bleeding, and to achieve the purpose of treatment without damaging the surrounding tissues of the target area. With the development of clinical research, it was found that the response of different adenomyosis lesions to HIFU ablation was not consistent, some patients were easy to obtain a good ablation rate, and some patients had poor ablation effect. However, the related factors are not clear. The purpose of this study was to analyze the factors influencing the effect of ultrasound ablation on adenomyosis from the three indexes of ablation rate, energy efficiency factor (EEF),) block and strong echo. To provide the basis for the optimal indications and optimal treatment of HIFU for adenomyosis. Objective to investigate the factors influencing the efficacy of HIFU in the treatment of adenomyosis. Materials and methods from January 2011 to July 2014, 245 patients with adenomyosis treated with HIFU in Haifu Hospital of Chongqing City were retrospectively analyzed. All patients underwent MRI enhanced scanning before and after HIFU treatment. The EEF and mass echo were set as dependent variables, and the factors that might affect the ablation efficacy were set up as independent variables to establish a multivariate regression model. Results all patients with adenomyosis underwent HIFU ablation at one time. There was a linear correlation between the type of enhancement, the thickness of abdominal wall, the volume of adenomyosis, the number of hyperintense bleeding points, the location of uterus, the location of adenomyosis and the ablation rate. The distance from the ventral side to the skin on T 1WI enhancement type, the volume of adenomyoma, the thickness of abdominal wall and the intensity of T2WI signal were linearly correlated with EEF. There is a linear relationship between the location of uterus and the thickness of abdominal wall. Conclusion the intensity of T2WI signal intensity, the volume of adenomyosis, the location of uterus, the location of adenomyosis, the number of hyperintense bleeding points, the thickness of abdominal wall and the distance from the ventral side of the lesion to the skin can be used as predictors for the curative effect of HIFU ablation of adenomyosis.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R711.71
本文編號(hào)：2172549
[Abstract]:High intensity focused ultrasound (High intensity focused) ablation is a newly developed noninvasive therapy technique. Because of its small trauma, quick recovery, accurate curative effect and so on, it can preserve the uterus and so on. The principle of HIFU ablation in the treatment of adenomyosis is to focus the low energy ultrasound on the adenomyosis in vitro. The thermal energy generated by ultrasonic at the focal point causes irreversible coagulation necrosis of the lesion, which causes ectopic endometrium to lose its function of growth and bleeding, and to achieve the purpose of treatment without damaging the surrounding tissues of the target area. With the development of clinical research, it was found that the response of different adenomyosis lesions to HIFU ablation was not consistent, some patients were easy to obtain a good ablation rate, and some patients had poor ablation effect. However, the related factors are not clear. The purpose of this study was to analyze the factors influencing the effect of ultrasound ablation on adenomyosis from the three indexes of ablation rate, energy efficiency factor (EEF),) block and strong echo. To provide the basis for the optimal indications and optimal treatment of HIFU for adenomyosis. Objective to investigate the factors influencing the efficacy of HIFU in the treatment of adenomyosis. Materials and methods from January 2011 to July 2014, 245 patients with adenomyosis treated with HIFU in Haifu Hospital of Chongqing City were retrospectively analyzed. All patients underwent MRI enhanced scanning before and after HIFU treatment. The EEF and mass echo were set as dependent variables, and the factors that might affect the ablation efficacy were set up as independent variables to establish a multivariate regression model. Results all patients with adenomyosis underwent HIFU ablation at one time. There was a linear correlation between the type of enhancement, the thickness of abdominal wall, the volume of adenomyosis, the number of hyperintense bleeding points, the location of uterus, the location of adenomyosis and the ablation rate. The distance from the ventral side to the skin on T 1WI enhancement type, the volume of adenomyoma, the thickness of abdominal wall and the intensity of T2WI signal were linearly correlated with EEF. There is a linear relationship between the location of uterus and the thickness of abdominal wall. Conclusion the intensity of T2WI signal intensity, the volume of adenomyosis, the location of uterus, the location of adenomyosis, the number of hyperintense bleeding points, the thickness of abdominal wall and the distance from the ventral side of the lesion to the skin can be used as predictors for the curative effect of HIFU ablation of adenomyosis.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R711.71
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 李發(fā)琪;王智彪;杜永洪;馬平;白晉;伍烽;馮若;;高強(qiáng)度聚焦超聲“切除”組織的劑量學(xué)研究[J];生物醫(yī)學(xué)工程學(xué)雜志;2006年04期
，本文編號(hào)：2172549
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