摘要【目的】探讨体素内不相干运动扩散加权磁共振成像(IVIM-DWI)在高强度聚焦超声(HIFU)治疗子宫肌瘤疗效中的评估价值。【方法】选取2018年1月至2019年3月在西安医学院附属宝鸡医院诊治的子宫肌瘤患者76例,均给予HIFU治疗,比较治疗前后IVIM-DWI参数,并分析其对HIFU治疗子宫肌瘤疗效的评估价值。【结果】治疗后真实扩散系数(D值)显著高于治疗前,而相关扩散系数(D*值)和灌注分数(f值)显著低于治疗前( P <0.05);肌瘤消融率>50%组D*值和f值变化值明显高于肌瘤消融率≤50%组( P <0.05);D*值和f值变化值预测肌瘤消融率>50%的ROC曲线下面积分别为0.681和0.901;截断值分别为16.71×10-3 mm2/s和15.70 mm2/s;灵敏性分别为58.60%和82.80%;特异性分别为77.80%和88.90%。【结论】IVIM-DWI参数对HIFU治疗子宫肌瘤疗效具有重要的评估价值,值得临床推广应用。
Abstract：【Objective】To explore the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in evaluating the efficacy of high intensity focused ultrasound (HIFU) in the treatment of uterine leiomyoma. 【Methods】A total of 76 patients with uterine leiomyoma treated in Baoji Hospital Affiliated to Xi'an Medical College from January 2018 to March 2019 were selected and treated with HIFU. The IVIM-DWI was performed before and after treatment and its predictive value for HIFU treatment was evaluated. 【Results】After treatment, the true diffusion coefficient (D) value higher than that before treatment ( P <0.05), while the correlation diffusion coefficient (D*) value and perfusion fraction (F value) were significantly lower than those before treatment ( P <0.05). The changes of D* and F values in the group with leiomyoma ablation rate > 50% were significantly higher than those in the group with leiomyoma ablation rate ≤50% ( P <0.05). The area under ROC curve for predicting ablation rate of leiomyoma > 50% by the changes of D* value and F value was 0.681 and 0.901,respectively. Meanwhile, the cut-off values were 16.71×10-3 mm2/s and 15.70 mm2/s, the sensitivity was 58.60% and 82.80%, and the specificity was 77.80% and 88.90%.【Conclusion】IVIM-DWI parameters have certain application value in predicting the efficacy of HIFU in the treatment of uterine leiomyoma, which is worthy of clinical use.
权晓华, 王康. 体素内不相干运动扩散加权磁共振成像在HIFU治疗子宫肌瘤疗效中的评估价值[J]. 医学临床研究, 2021, 38(3): 379-381.
QUAN Xiao-hua, WANG Kang. Value of Intravoxel Incoherent Motion Diffusion Weighted Imaging in Evaluating Efficacy of HIFU in the Treatment of Uterine Leiomyoma. JOURNAL OF CLINICAL RESEARCH, 2021, 38(3): 379-381.
2021, Vol. 38 
