一超声造影在经皮微波消融治疗子宫肌层良性病变围手术期中的作用•52•January2012,Vol9,No.1中华医学超声杂志（电子版）2012年1月第9卷第1期ChinJMedUltrasound（ElectronicEdition）,•妇产科超声影像学•超声造影在经皮微波消融治疗子宫肌层良性病变围手术期中的作用王芳张晶韩治宇程志刚周洪雨【摘要】目的方法探讨超声造影在经皮微波消融治疗子宫肌层良性病变围手术期中的应用价值。采用微波消融治疗仪对22例患者24个子宫肌层良性病灶（子宫肌壁间、黏膜下和浆膜下肌瘤22例患16个、弥漫性和局限性腺肌病病灶8个）进行微波消融治疗。微波治疗前、治疗后即刻和治疗后12〜24h均行超声造影，观察消融灶增强表现，并对无造影剂灌注区体积进行测量。结果14例子宫肌瘤16个病灶呈周边强化方式，8例腺肌者微波治疗前后超声造影图像特征：微波治疗前，病8个病灶快速优先增强，峰值吋病灶与周围肌层分界不清晰。微波消融后即刻，超声造影显示24个消融灶呈边缘毛糙的类球形或不规则形无增强区，内可见线状、片状热场未消散所致的高增强。19个消融灶显示为边界较锐利、微波消融后12~24h内再次造影，均匀一致的无增强。微波消融后3即刻超声造影显示无造影剂灌注区体积为(83.41±72.83)cm,小于微波消融后12~24h的(94.73±80・37)cm3,P=0.267)□结论但差异无统计学意义(t=l.138,再次超声造影检查可较准确判断治疗后消融灶坏死范围。【关键词】超声检查；造影剂；子宫肿瘤；微波；消融在子宫肌瘤和子宫腺肌病经皮微波消融治疗术前及术后超声造影显示微波消融区图像变化特点鲜明，消融治疗后12〜24h内Perioperativeeffectofcontrast-enhancedultrasoundinpercutaneousmicrowaveablationofuterineWANGFang,ZHANGJing,HANZhi-yu,CHENGZhi-gang,ZHOUHong-yu・musclebenignlesionsDepartmentoflnterventionalUltrasound,GeneralHospitalofThePeople'sLiberationArmy,Beijingl00853,ChinaCorrespondingauthor：ZHANGJing,Email：zjbch@vip.sina.com[Abstract]ObjectiveToassessthevalueofcontrast-enhancedultrasound(CEUS)inevaluatingthetherapeuticefficacyofpercutaneousmicrowaveablationonbenignuterinemusclelesions.MethodsUltrasound-guided(US)percutaneousmicrowaveablationwasperformedon22patientswith24uterinemuscularisbenignlesions(16intramural,submucosalandsubserosalmyomas,8uterineimmediatelyafterandl2・24hoursaftertreatment,adenomyosis)・CEUSwasperformedon22patientsbefore,andtheenhancedpatternofalllesionswasobserved・Thenon・enhancedvolumeswascomparedimmediatelyandl2・24hoursafterabla廿on.ResultsBeforeablation,ofallthe22cases,14casesofl6uterinemyomasexhibitedperipheralenhancementpattern；8adenomyosislesionsexhibitedfastenhancement,theboundaryofthelesionandthesurroundingmusclewasnotclearsubsequently.Immediatelyaftermicrowaveablation,non-enhancedablationareasofl9lesionsweresphericalorirregularshapedwithroughedges.Linearandflakeenhancementsweredetectedintheablationareaowingtothepersistenceofthermalfield・Twelveto24hoursafterablation,theablatedboundaryofl7lesionswererelativelysharp,andthenon・enhancedareawas3uniform・Theablationvolumeimmediatelyaftertreatment(83.41±72.83)cmwassmallerthanthevolume12-24hoursaftertreatment(94.73±80・37)cm3,buttheywerenotsignificantlydifferent(t=l.138,P=0.267).Conclusionslnpercutaneousmicrowaveablationofuterinemusclebenignlesions,theCEUSimagesexhibiteddistinctcharacteristics・CEUSwithinl2-24hoursaftermicrowaveablationcanaccuratelydeterminethescopeofpostoperativenecrosis・[Keywords]Ultrasonography；Contrastmedia；Uterineneoplasns；Microwave；Ablation子宫肌层良性病变中以子宫肌瘤和子宫腺肌病多见，超声引导下经皮穿刺微波消融治疗子宫肌瘤DOI：10.3877/cma.j.issn.1672-644&2012.01.014作者单位：100853北京，解放军总医院介入超声...