Can measurement of apparent diffusion coefficient before treatment predict the response to uterine artery embolization for adenomyosis?
Can measurement of apparent diffusion coefficient before treatment predict the response to uterine artery embolization for adenomyosis?
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DOI：
10.1007/s00330-014-3504-3
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发表时间：
2015-03-01
影响因子：
5.9
通讯作者：
Lee, Do Yun
中科院分区：
文献类型：
--
作者：
Park, Yaewon;Kim, Man Deuk;Lee, Do Yun
为了确定表观弥散系数（ADC）在预测子宫动脉栓塞（UAE）治疗症状性子宫腺肌病的疗效中的作用，对2011年6月至2012年12月间25例在UAE前接受弥散加权（DW）磁共振成像（MRI）的患者进行了前瞻性研究。所有患者在UAE后接受了3个月的随访MRI，使用非球形聚乙烯醇（PVA）颗粒，范围从150 μ m到500 μ m。对每种子宫腺肌病进行ADC定量测量。完全缓解和不完全缓解分别定义为随访MRI时子宫腺肌病非灌注区的千分之90%或<90%。根据UAE后MRI检查结果，比较完全缓解和不完全缓解患者的ADC值，完全缓解19例，不完全缓解6例。ADC值范围为0.842至1.346 x 10（-3）mm（2）/s（平均值为1.075 +/- 0.117）。完全缓解组的平均ADC为1.043 +/- 0.237，不完全缓解组为1.176 +/- 0.429（0.012）。使用< 1.147 x 10（-3）mm（2）/s的阈值，ADC值预测UAE成功的敏感性和特异性分别为83.3%和84.2%，子宫腺肌病的ADC值可能预测UAE治疗子宫腺肌病的成功率。程序性MRI可能有助于临床医生预测子宫内膜异位症的UAE反应。用于咨询有症状的子宫腺肌病患者。
To determine the usefulness of the apparent diffusion coefficient (ADC) in predicting response to uterine artery embolization (UAE) for symptomatic adenomyosis.A prospective study was performed on 25 patients who underwent diffusion-weighted (DW) magnetic resonance imaging (MRI) before UAE between June 2011 and December 2012. All patients underwent 3-month follow-up MRI after UAE using non-spherical polyvinyl alcohol (PVA) particles ranging from 150 to 500 mu m. Quantitative measurement of the ADC was performed for each adenomyosis. Complete response and incomplete response were defined as a parts per thousand yen90 % or < 90 %, respectively, of the non-perfusion area with adenomyosis at the follow-up MRI. The ADC values were compared between patients who achieved complete or incomplete response which was assessed according to the MRI findings after UAE.Nineteen patients showed complete response, and six showed incomplete response. The ADC value ranged from 0.842 to 1.346 x 10(-3) mm(2)/s (mean 1.075 +/- 0.117). The mean ADC was 1.043 +/- 0.237 in the complete response group and 1.176 +/- 0.429 in the incomplete response group (0.012). Using a threshold of < 1.147 x 10(-3) mm(2)/s, the sensitivity and specificity of the ADC to predict success after UAE were 83.3 % and 84.2 %.The ADC of adenomyosis may potentially predict a successful response to UAE for adenomyosis.aEuro cent Pre-procedural MRI might help clinicians predict response of UAE in adenomyosisaEuro cent ADC might help predict UAE outcomes in adenomyosisaEuro cent MR predictors might be used to counsel patients with symptomatic adenomyosis.