Reasons for different therapeutic effects of high-intensity focused ultrasound ablation on excised uterine fibroids with different signal intensities on T2-weighted MRI: a study of histopathological characteristics
Reasons for different therapeutic effects of high-intensity focused ultrasound ablation on excised uterine fibroids with different signal intensities on T2-weighted MRI: a study of histopathological characteristics
复制标题
T2加权MRI不同信号强度高强度聚焦超声消融切除子宫肌瘤疗效不同的原因：组织病理学特征研究
DOI：
10.1080/02656736.2019.1592242
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发表时间：
2019-01-01
影响因子：
3.1
通讯作者：
Li, Faqi
中科院分区：
文献类型：
--
作者：
Huang, Haoran;Ran, Jianbo;Li, Faqi
目的：探讨高强度聚焦超声(HIFU)治疗子宫肌瘤的疗效与T2加权磁共振成像(MRI)上不同信号强度子宫肌瘤的组织病理学特征的相关性。方法：收集47例子宫肌瘤手术切除标本，按术前MRI T2加权像低信号、等信号、不均匀信号和均匀高信号分为4组。然后，用相同参数的HIFU照射各组标本，计算坏死区的体积。定量检测并比较不同组间的平滑肌细胞计数和胶原纤维含量。结果：从低信号组到均匀高信号组，坏死组织体积逐渐减小(p=.008)。低信号组至均匀高信号组的SMC计数分别为215.659.3、237.0(89.5)、232.3+/-72.5、330.5+/-30.9，胶原纤维含量分别为0.65+/-0.07、0.64+/-0.10、0.53+/-0.11、0.41+/-0.06。四组之间的比较显示，从低信号组到均匀高信号组，SMC计数逐渐增加(p=.001)，而胶原纤维含量逐渐减少(p=.000)。相关分析显示，坏死组织体积与子宫平滑肌细胞计数呈负相关(R=-0.488，p=0.013)，与胶原纤维含量呈正相关(R=0.534，p=0.005)。结论：组织病理学特征的差异可能是高强度聚焦超声治疗不同T2加权信号子宫肌瘤疗效不同的原因之一。
Objective: The objective of this study was to explore the correlations between the therapeutic effect of high intensity focused ultrasound (HIFU) and histopathological characteristics of excised uterine fibroids with different signal intensities as visualized on T2-weighted magnetic resonance imaging (MRI).Methods: We collected 47 specimens of uterine fibroids after surgical resection and classified them into four groups according to preoperative T2-weighted MRI hypo-intense, isointense, heterogeneous intense and homogeneous hyper-intense. Then, specimens in each group were irradiated by HIFU with the same parameters and the necrotic tissue volume was calculated. The smooth muscle cell (SMC) count and collagen fiber content were quantitatively measured and compared between different groups. We analyzed the correlation between the necrotic tissue volume and SMC count and the collagen fiber content.Results: Necrotic tissue volume gradually decreased from the hypo-intense group to the homogeneous hyper-intense group (p=.008). The SMC count from the hypo-intense group to the homogeneous hyper-intense group was 215.659.3, 237.0(89.5), 232.3 +/- 72.5 and 330.5 +/- 30.9, respectively; collagen fiber content was 0.65 +/- 0.07, 0.64 +/- 0.10, 0.53 +/- 0.11 and 0.41 +/- 0.06, respectively. Comparison among the four groups showed that SMC count progressively increased (p=.001) but collagen fiber content progressively decreased (p=.000) from the hypo-intense group to the homogeneous hyper-intense group. Correlation analysis showed that necrotic tissue volume was negatively correlated with SMC count (R=-0.488, p=.013) but positively correlated with collagen fiber content (R=0.534, p=.005).Conclusions: Differences in histopathological characteristics may be one of the reasons for different therapeutic effects of HIFU ablation on uterine fibroids with different signal intensities on T2-weighted MRI.