CAJ | 학술논문

目的：探讨超声造影对高强度聚焦超声（HIFU ）治疗子宫肌瘤及腺肌病即刻评价及补充治疗的应用价值。方法57例子宫肌瘤患者（67个病灶），31例子宫腺肌病患者（41个病灶），采用JC-200型 HIFU 治疗系统，在B超监控下对病灶进行HIFU治疗，治疗前、后即刻应用机载超声造影观察病灶血流灌注变化并及时引导补充治疗，计算消融率及补充治疗后消融率，对早期疗效作出判断。结果 HIFU治疗后超声造影显示57例子宫肌瘤患者平均消融率为（84．6±16．1）％，其中9例治疗后超声造影检查提示病灶边缘局部仍有灌注，及时补充治疗后57例患者平均消融率提高为（87．0±10．7）％，前后平均消融率比较差异无统计学意义（ P＞0．05）。31例子宫腺肌病患者平均消融率为（62．0±22．7）％，其中11例经补充治疗后31例最终平均消融率为（74．0±14．7）％，前后平均消融率比较差异有统计学意义（P＜0．05）。结论超声造影可用于评价 HIFU治疗子宫肌瘤及腺肌病的消融范围及程度，明确病灶残存部位及时引导补充治疗，提高消融率，为早期疗效判断提供依据。
목적：탐토초성조영대고강도취초초성（HIFU ）치료자궁기류급선기병즉각평개급보충치료적응용개치。방법57례자궁기류환자（67개병조），31례자궁선기병환자（41개병조），채용JC-200형 HIFU 치료계통，재B초감공하대병조진행HIFU치료，치료전、후즉각응용궤재초성조영관찰병조혈류관주변화병급시인도보충치료，계산소융솔급보충치료후소융솔，대조기료효작출판단。결과 HIFU치료후초성조영현시57례자궁기류환자평균소융솔위（84．6±16．1）％，기중9례치료후초성조영검사제시병조변연국부잉유관주，급시보충치료후57례환자평균소융솔제고위（87．0±10．7）％，전후평균소융솔비교차이무통계학의의（ P＞0．05）。31례자궁선기병환자평균소융솔위（62．0±22．7）％，기중11례경보충치료후31례최종평균소융솔위（74．0±14．7）％，전후평균소융솔비교차이유통계학의의（P＜0．05）。결론초성조영가용우평개 HIFU치료자궁기류급선기병적소융범위급정도，명학병조잔존부위급시인도보충치료，제고소융솔，위조기료효판단제공의거。
Objective To investigate the application of ultrasound visualization in instantly evaluation and supplement therapeu-tics in the treatment of uterine fibroids and adenomyosis with high intensity focused ultrasound (HIFU ) .Methods 57 patients with 67 uterine fibroids and 31 patients with 41 adenomyosis were treated with JC-200 HIFU treatment system and monitored the blood flow change in the lesion with B-ultrasound .Evaluated the curative effect with ablation ratio and ablation ratio after supplement therapeutics .Results The average ablation ratio of 57 uterine fibroids was(84 .6 ± 16 .1)% and the increased to(87 .0 ± 10 .7)% af-ter supplement therapeutics to 9 lesions with blood flow in the border of all .The changes were no significance(P>0 .05) .The aver-age ablation ratio of 31 adenomyosis was(62 ± 22 .7)% and increased to(74 ± 14 .7)% after supplement therapeutics to 11 lesions with blood flow in the border of all .The changes were statically significance(P<0 .05) .Conclusion Ultrasound visualization could be used to evaluate the area and extent of ablation with HIFU therapy ,it can clear lesions remaining parts and guiding the supple-ment therapeutics to improve the ablation ratio .Ultrasound visualization provided an evidence of therapeutics in the early period .