CAJ | 학술논문

目的探讨灰阶超声造影（CEUS）在子宫肌瘤自凝刀射频消融治疗中的应用价值。方法超声导向经阴道自凝刀射频消融（RFA ）治疗前分别对59例已育妇女71个子宫肌瘤（其中肌壁间肌瘤22个，黏膜下肌瘤49个）行常规超声及CEUS检查，RFA治疗后即刻行CEUS检查来评判消融效果，部分带蒂黏膜下肌瘤消融后随即取出送病理。治疗后于3，6，12月常规超声观察肌瘤体积变化、血供及患者临床症状改善情况。结果术前行CEUS检查71个病灶均符合子宫肌瘤“周边网状增强型”的造影增强模式；RFA 术后即刻病灶CEUS表现为“缺损型”造影增强模式。RFA术后3，6，12月肌瘤平均体积明显缩小，差别有统计学意义。结论 RFA术前、术后即刻CEUS的应用，严格掌握手术适应症有助于提高RFA治疗子宫肌瘤的疗效。
목적탐토회계초성조영（CEUS）재자궁기류자응도사빈소융치료중적응용개치。방법초성도향경음도자응도사빈소융（RFA ）치료전분별대59례이육부녀71개자궁기류（기중기벽간기류22개，점막하기류49개）행상규초성급CEUS검사，RFA치료후즉각행CEUS검사래평판소융효과，부분대체점막하기류소융후수즉취출송병리。치료후우3，6，12월상규초성관찰기류체적변화、혈공급환자림상증상개선정황。결과술전행CEUS검사71개병조균부합자궁기류“주변망상증강형”적조영증강모식；RFA 술후즉각병조CEUS표현위“결손형”조영증강모식。RFA술후3，6，12월기류평균체적명현축소，차별유통계학의의。결론 RFA술전、술후즉각CEUS적응용，엄격장악수술괄응증유조우제고RFA치료자궁기류적료효。
Objective To explore the clinical value of contrast-enhanced ultrasound(CEUS) in the treatment of uterine myoma with radiofrequency ablation (RFA ) . Methods 59 patients with 71 uterine myoma (22 intramural fibroids and 49 submucosal fibroids) were examinated by routine ultrasound and CEUS before RFA . CEUS was performed immediately after the RFA treatment to assess the efficacy , and partially pedunculated submucosal fibroids were removed and sent for pathological analysis right after the ablation . 3 ,6 and 12 months after the treatment ,the volumes and blood flow s of the fibroids and changes of clinical symptom were evaluated . Results The enhancement patterns of all tumors were pe-ripheral net pattern ,while after RFA lesions were un-enhanced with CEUS . 3 ,6 and 12 months after the RFA treatment ,the average volumes of fibroids significantly became smaller ,and the difference was of statistic significance . Conclusion CEUS applicated preoperatively and postoperatively can improve the efficacy in the treatment of uterine myoma with RFA .