Objective To observe the relationship of efficacy of high-intensity focused ultrasound (HIFU) in treatment of hysteromyoma and quantitative parameters and enhance manifestations of CEUS.Methods Forty patients with single hysteromyoma underwent CEUS before HIFU,immediately after and 6 months after treatment,respectively.Time to peak (TTP),peak intensity (PI) of time-intensity curve were analyzed,and the enhance manifestations were observed.The ablation ratio of hysteromyoma immediately after HIFU and the ratio of reduction volume 6 months after treatment were also analyzed.Results Among 40 hysteromyomas,21 evenly enhanced (even enhance group) and 19 unevenly enhanced (uneven enhance group).The ablation rate greater than or equal to 80 ％ were observed in 22 hysteromyomas (ablation rate ≥80％ group),while ablation rate less than 80％ were observed in 18 lesions (ablation rate ＜80％ group).There were significant differences of TTP ([27.48 ± 7.89] s vs [21.78 ± 4.76] s;t =2.69,P =0.01),PI ([44.29 ± 3.74] dB vs [47.39±4.68]dB;t=-2.34,P=0.02) and the ratio of reduction volume 6 months after HIFU ([59.47±16.21]％ vs [37.30±11.89]％;t=4.83,P＜0.01) between ablation rate ≥80％ group and ablation rate ＜80％ group.The ablation rate ([65.03±18.39]％ vs [41.64±18.78]％;t=-4.49,P＜0.01) and the ratio of reduction volume 6 months after HIFU ([84.74±7.76]％ vs [58.18±12.94]％;t=-3.21,P＜0.01) were significantly different between even enhance group and uneven enhance group.TTP and the ratio of reduction volume 6 months after HIFU positively correlated with the ablation rate (r =0.448,0.660,both P＜ 0.01),while PI and enhance manifestations negatively correlated with ablation rate (r =-0.460,rs =-0.614,both P＜ 0.01).Conclusion TTP,PI of time-intensity curve and enhance patterns of hysteromyoma correlated with the ablation rate of HIFU,which having certain clinical value in evaluation of therapeutic efficacy.%目的 探讨CEUS定量参数及增强形态与高强度聚焦超声(HIFU)治疗子宫肌瘤疗效的关系.方法 对40例单发子宫肌瘤患者分别于HIFU治疗前、治疗后即刻及治疗后6个月行CEUS检查,分析时间-强度曲线达峰时间(TTP)、达峰强度(PI),观察肿瘤增强形态.并分析HIFU治疗后即刻病灶消融率及治疗后6个月病灶体积缩小率.结果 40例患者共40个子宫肌瘤病灶中,21个呈均匀增强(均匀增强组),19个呈不均匀增强(不均匀增强组).22个病灶消融率≥80％(消融率≥80％组),18个病灶消融率＜80％(消融率＜80％组).消融率≥80％与消融率＜80％组间TTP[(27.48±7.89)svs (21.78±4.76)s;t=2.69,P=0.01]、PI[(44.29±3.74)dB vs (47.39±4.68) dB;t=-2.34,P=0.02]、HIFU治疗后6个月病灶体积缩小率[(59.47±16.21)％ vs (37.30±11.89)％;t=4.83,P＜0.01]差异均有统计学意义.均匀增强与不均匀增强组间消融率[(65.03±18.39)％ vs (41.64±18.78)％;t=-4.49,P＜0.01]、HIFU治疗后6个月病灶体积缩小率[(84.74±7.76)％ vs (58.18±12.94)％;t=-3.21,P＜0.01]差异均有统计学意义.TTP、HIFU治疗后6个月病灶体积缩小率均与消融率呈正相关(r=0.448、0.660,P均＜0.01),PI、增强类型均与消融率呈负相关(r=-0.460、rs=-0.614,P均＜0.01).结论 子宫肌瘤CEUS时间-强度曲线TTP、PI和增强形态均与HIFU消融率间存在相关性,其在疗效评估方面具有一定的临床价值.
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