The Value Of Functional Magnetic Resonance Imaging (fMRI) In Uterine Fibroids After High Intensity Focused Ultrasound(HIFU)

Objective: To analyse the value of3.0T functional magnetic resonanceimaging in evaluating the efficacy and prognosis of uterine fibroids after highintensity focused ultrasound.Materials and Methods:192patients with522uterine fibroids acceptedHIFU treatment and underwent MRI plain,dynamic contrast-enhanced MRIand multi-b values Diffusion Weighted Imaging scanning at3.0T MRI withinone day before and after HIFU.Among them,48patients with111uterinefibroibs were followed up regularly,using the same sequence and scanningparameters to scan after three monthes,six mothes,one year.Observe andrecord the change of the number,volume,location,type,non-perfusion arearatio, average ADC value of multi-b value,the absolute signal strength ofT1WI enhanced,T1WI and T2WI before and after HIFU.the symptomseverity score represents the change of symptoms.Results: This study collected192patients with522uterine fibroids,among them,486uterine fibroids accepted HIFU treatment, the rest cannot betreated due to the small size, posterior position on the airborne ultrasound.Nosevere complication in all patients during and after operation, postoperativeenhanced magnetic resonance shows all the ablation lesions showedsignificant non perfusion area, the rim enhancement, the blood supply ofuterine fibroids were occluded. In48cases with111uterine fibroids ofregularly follow-up:1, located on the bottom wall, anterior wall, posterior wall, side walls are respectively accounted for15.3%(17/111),39.6%(44/111),24.3%(27/111),20.7%(23/111), postoperative leiomyoma ablationrate have significant relationship with the fibroids’ location, the fibroids onthe anterior wall had better efficacy,the fibroids on the posterior wall, bottomwall, side wall had no significant difference.2,the uterine fibroid meanvolume value before HIFU treatment is96.75cm3, the average volume were93.25cm3,48.62cm3,28.88cm3,20.75cm3postoperative1day,3months,6months, one year; the minification was3.6%,49.7%,70.1%,78.6%respectively,after pair analysis of SNK test, in addition to the preoperativeand postoperative1day,6months and12months after operation had nosignificant difference, the others had statistical significance. Group ofdifferent ablation volume, and analysis with postoperative follow-up SSSscore at different time with the repeated measures analysis of variance, theresult showed that the ablation volume greater than75%, the recovery ofpatients was the best.3, before HIFU treatment,the number of uterinefibroids of low T2-weighted signal intensity is72, isointensity7, highT2-weighted signal intensity4, heterogeneous intensity28, uterine fibroids indifferent T2WI signal intensity strength had statistical significance, fibroidsfibroids of low T2-weighted signal intensity had the better efficacy,so weresome of the uterine fibroids of high T2-weighted signal intensity.4,Theaverage absolute signal intensity of T1WI, T2WI, DCE-MRI enhanced scanbefore HIFU treatment were996.45±190.99,480.18±162.20,1954.56±238.84, one day after treatment were1107.67±214.94,429.41±139.16,1249.07±159.77, T1WI absolute signal strength increased significantly aftertreatment, T2WI absolute signal intensity decreased mildly, DCE-MRIabsolute signal strength increased significantly.5, before the HIFU treatment, multi-b value average ADC value was (1.018±0.177)×10‐3mm2/s, theaverage ADC was (0.965±0.172)×10‐3mm2/s,(0.870±0.136)×10‐3mm2/s(0.773±0.091)×10‐3mm2/s,(0.862±0.035)×10‐3mm2/s respectively onpostoperative day,three monthes,six mothes,one year, and the results indicatedthat the average ADC decreased significantly after HIFU, and continued to6months, but had rebound in ADC after one year.Conclusions:(1)HIFU is effective significantly,non-invasive and safe inthe treatment of uterine fibroids,patients’receiving is high.(2)3.0T MRIfunctional imaging can effectively evaluate the efficacy of high intensityfocused ultrasound in treatment of uterine fibroids,assessment ofprognosis,sensitivity and high accuracy,It can be used for long-term follow-up.(3)The position and signal strength of leiomyoma can affect the result ofablation.