HIFU非侵入性阻断血管治疗子宫肌瘤的初步探索.docVIP

HIFU非侵入性阻断血管治疗子宫肌瘤的初步探索 作者：欧阳艳文,刘小云,潘泽魁 单位：广西贺州市人民医院超声科，广西贺州542800 【摘要】 目的 探讨高强度聚焦超声（HIFU）非侵入性阻断肌壁间肌瘤假包膜内层血管网以治疗子宫肌瘤的安全性和有效性。方法 11例直径4～10cm子宫肌壁间肌瘤，HIFU前通过彩色多普勒血流成像(CDFI)确定肌瘤假包膜内血供起始部，并对此区域进行了HIFU治疗，通过临床症状观察，治疗前后CDFI和MRI、影像学变化、并发症情况等观察HIFU的治疗效果。结果 治疗后部分患者临床症状消失或明显改善，瘤体假包膜环状血流信号消失，瘤体有不同程度的缩小及坏死。结论 HIFU针对瘤体假包膜内血管始端治疗以阻断肌瘤血供使其自然萎缩是一种较为人性化、非侵入性和安全有效的方法。 【关键词】 高强度聚焦超声；子宫肌瘤；血行阻断 HIFU in non-invasive blocking blood supply for treatment of hysteromyoma　OUYANG Yan-wen, LIU Xiao-yun, PAN Zhe-kui　Department of Ultrasound, Hezhou Peoples Hospital, Hezhou, Guangxi 542800, China Abstract: Objective To study the effectiveness and reliability of high intensity focused ultrasound (HIFU) in non-invasive blocking inner vascular network of the pseudomembrane between the uterine walls for treatment of hysteromyoma. Methods Before HIFU, the blood origins in the false capsule of the myoma were monitored by using CDFI for 11 cases of hysteromyoma with 4～10 cm diameter between the uterine walls, and HIFU treatment was carried out for this focal region. The changes of the clinical symptoms, the changes of the presentation images of CDFI and MRI before and after HIFU treatment and complications were used to evaluate the effectiveness of HIFU treatment. Results Some patients clinical symptom disappeared or improved after treatment, and annular blood flow signals of pseudocapsule in tumor body disappeared with the diminution and necrosis of the tumors at different extents. Conclusion The therapy for hysteromyoma, with HIFU blocking the blood supply to reduce mass naturally, is a humanized, noninvasive, safe and effective way. 　　Key words: high intensity focused ultrasound; hysteromyoma; devascularization 高强度聚焦超声(HIFU)是新近发展较为迅速的一种非侵入性治疗实体肿瘤的新技术。我院于2007年9月～2008年6月利用HIFU治疗11例肌壁间子宫肌瘤患者，非侵入性地成功阻断瘤体假包膜内血管，使肌瘤去血管化后逐步吸收缩小并消失，现初步报告如下。 　　1 资料与方法 　　1.1 一般资料 　　11例绝经前患者，年龄31～54岁，平均39.18岁。根据3次常规超声及彩色多普勒血流成像（CDFI）临床诊断为肌壁间子宫肌瘤，其中肌瘤位于前壁5例，位于后壁3例，位于右底前壁2例，位于右侧壁1例（均为单发），肌瘤大小直径40～100mm， 平均62mm。患者临床症状：经期延长、痛经