Uterine fibroids: Diffusion-weighted MR imaging for monitoring therapy with focused ultrasound surgery - Preliminary study
Uterine fibroids: Diffusion-weighted MR imaging for monitoring therapy with focused ultrasound surgery - Preliminary study
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DOI：
10.1148/radiol.2361040312
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发表时间：
2005-07-01
期刊：
影响因子：
19.7
通讯作者：
Kim, HS
中科院分区：
文献类型：
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作者：
Jacobs, MA;Herskovits, EH;Kim, HS
目的：前瞻性探讨应用弥散加权（DW）成像及表观弥散系数（ADC）作图在治疗前（基线）、治疗后及随访6个月监测磁共振（MR）图像引导下聚焦超声子宫肌瘤手术消融的可行性。材料和方法：在我们的研究方案治疗前获得患者的知情同意，经机构审查委员会批准，该研究符合《健康保险流通与责任法案》。本研究纳入14例接受DW成像的患者（平均年龄46岁+/- 5岁[标准差]），其中12例在随访6个月时完成了DW成像的包容性MR检查。治疗由一名放射科医生使用改良的磁共振图像引导聚焦超声手术系统结合1.5 t磁共振成像仪进行。通过相位敏感t1加权快速破坏梯度回忆采集，t1加权造影剂增强和DW成像序列获得治疗前后和6个月随访的MR图像。总治疗时间1 ~ 3小时。构建痕量ADC图进行定量分析。在对比后图像上绘制定位于DW图像上高强度区域的感兴趣区域，并在治疗前后和6个月随访时对治疗和未治疗的子宫组织进行定量统计。采用方差分析进行统计分析。P < 0.05为差异有统计学意义。结果：选择治疗的t1加权增强肌瘤在治疗前DW图像或ADC图上无高或低信号强度变化。在DW图像上发现，在治疗区域内明显增加的信号强度变化。肌瘤的平均基线ADC值为1504 mm(-6)/秒(2)+/- 290。未治疗的肌瘤组织治疗后ADC值(1685 mm（-6)/sec(2) 468）与治疗后肌瘤组织ADC值(1078 mm（-6)/sec(2) +/- 293）不同（P = .001）。在6个月的随访中，治疗组(1905 mm（-6)/sec(2) +/- 446）和未治疗组(1437 mm（-6)/sec(2) +/- 270）的肌瘤组织ADC值有显著差异（P < 0.001）。结论：超声聚焦治疗子宫肌瘤后，DW显像和ADC显像对消融组织的鉴别是可行的。(c) RSNA， 2005年。
PURPOSE: To prospectively determine the feasibility of using diffusion-weighted (DW) imaging and apparent diffusion coefficient (ADC) mapping before (baseline) and after treatment and at 6-month follow-up to monitor magnetic resonance (MR) image-guided focused ultrasound surgical ablation of uterine fibroids.MATERIALS AND METHODS: Informed consent was obtained from patients before treatment with our study protocol, as approved by the institutional review board, and the study complied with the Health Insurance Portability and Accountability Act. Fourteen patients (mean age, 46 years +/- 5 [standard deviation]) who underwent DW imaging were enrolled in this study, and 12 of 14 completed the inclusive MR examination with DW imaging at 6-month follow-up. Treatment was performed by one radiologist with a modified MR image-guided focused ultrasound surgical system coupled with a 1.5-T MR imager. Pre- and posttreatment and 6-month follow-up MR images were obtained by using phase-sensitive T1-weighted fast spoiled gradient-recalled acquisition, T1-weighted contrast material-enhanced, and DW imaging sequences. Total treatment time was 1-3 hours. Trace ADC maps were constructed for quantitative analysis. Regions of interest localized to areas of hyperintensity on DW images were drawn on postcontrast images, and quantitative statistics were obtained from treated and nontreated uterine tissue before and after treatment and at 6-month follow-up. Statistical analysis was performed with analysis of variance. Differences with P < .05 were considered statistically significant.RESULTS: T1-weighted contrast-enhancing fibroids selected for treatment had no hyperintense or hypointense signal intensity changes on the DW images or ADC maps before treatment. Considerably increased signal intensity changes that were localized within the treated areas were noted on DW images. Mean baseline ADC value in fibroids was 1504 mm(-6)/sec(2) +/- 290. Posttreatment ADC values for nontreated fibroid tissue (1685 mm(-6)/sec(2) 468) differed from posttreatment ADC values for fibroid tissue (1078 mm(-6) /sec(2) +/- 293) (P = .001). A significant difference (P < .001) between ADC values for treated (1905 mm(-6)/sec(2) +/- 446) and nontreated (1437 mm(-6) /sec(2) +/- 270) fibroid tissue at 6-month follow-up was observed.CONCLUSION: DW imaging and ADC mapping are feasible for identification of ablated tissue after focused ultrasound treatment of uterine fibroids. (c) RSNA, 2005.