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Abstract：
OBJECTIVE: This study aimed to explore the clinical value of magnetic resonance imaging (MRI) combined with ultrasound-guided high-intensity focused ultrasound (USg-HIFU) for the diagnosis and treatment of abdominal wall endometriosis (AWE).
METHODS: Magnetic resonance imaging was performed before and after USg-HIFU. Information on clinical characteristics of patients, MRI characteristics of lesions, and treatment outcomes were collected. Thirty AWE lesions in 29 patients were examined before HIFU treatment, while 27 patients were examined after treatment. The results of MRI and color doppler ultrasound before surgery, as well as the volume and the apparent diffusion coefficient (ADC) values of the lesions before and after USg-HIFU treatment were compared. We also observed the clinical symptoms remission, recurrence, and ablation rates of the lesions in follow-up after HIFU treatment.
RESULTS: The locations of the 30 AWE lesions were identified by MRI before USg-HIFU treatment. Their sizes appeared larger on MRI than ultrasound (P < 0.05). A total of 27 lesions were evaluated by MRI after USg-HIFU treatment, of which 92.6% (25/27) lesions were of high or slightly high signal intensity on T1-weighted images, and 77.8% (21/27) lesions were of mixed signal intensity on T2-weighted images. The mean ADC values of AWE lesions were 1.47 (1.20-1.59) × 10-3mm2/s and 1.86 (1.61-2.12) × 10-3mm2/s for pre-and post-HIFU treatment (P < 0.05). Patients with higher ablation rates (>50%) had a higher complete/partial remission rate than those with lower ablation rates (<50%), and had a lower recurrence rate (P < 0.05).
CONCLUSIONS: MRI is a useful tool for identifying the location, size, and concurrent changes of AWE before and after USg-HIFU treatment, which is beneficial for follow-up monitoring and defining treatment efficacy.
METHODS: Magnetic resonance imaging was performed before and after USg-HIFU. Information on clinical characteristics of patients, MRI characteristics of lesions, and treatment outcomes were collected. Thirty AWE lesions in 29 patients were examined before HIFU treatment, while 27 patients were examined after treatment. The results of MRI and color doppler ultrasound before surgery, as well as the volume and the apparent diffusion coefficient (ADC) values of the lesions before and after USg-HIFU treatment were compared. We also observed the clinical symptoms remission, recurrence, and ablation rates of the lesions in follow-up after HIFU treatment.
RESULTS: The locations of the 30 AWE lesions were identified by MRI before USg-HIFU treatment. Their sizes appeared larger on MRI than ultrasound (P < 0.05). A total of 27 lesions were evaluated by MRI after USg-HIFU treatment, of which 92.6% (25/27) lesions were of high or slightly high signal intensity on T1-weighted images, and 77.8% (21/27) lesions were of mixed signal intensity on T2-weighted images. The mean ADC values of AWE lesions were 1.47 (1.20-1.59) × 10-3mm2/s and 1.86 (1.61-2.12) × 10-3mm2/s for pre-and post-HIFU treatment (P < 0.05). Patients with higher ablation rates (>50%) had a higher complete/partial remission rate than those with lower ablation rates (<50%), and had a lower recurrence rate (P < 0.05).
CONCLUSIONS: MRI is a useful tool for identifying the location, size, and concurrent changes of AWE before and after USg-HIFU treatment, which is beneficial for follow-up monitoring and defining treatment efficacy.
摘要：
目的：本研究旨在探讨磁共振成像(MRI)联合超声引导下高强度聚焦超声(USg-HIFU)在腹壁子宫内膜异位症(AWE)诊治中的临床价值。
方法：在USg-HIFU前后进行磁共振成像。有关患者临床特征的信息，病变的MRI特征,并收集治疗结果.29例患者在HIFU治疗前检查了30个AWE病灶，治疗后对27例患者进行了检查。术前MRI和彩色多普勒超声检查结果,比较了USg-HIFU治疗前后病灶的体积和表观扩散系数(ADC)值.我们还观察到临床症状缓解，复发,HIFU治疗后随访病灶的消融率。
结果：在USg-HIFU治疗前通过MRI确定30个AWE病灶的位置。MRI显示其大小大于超声检查（P<0.05）。USg-HIFU治疗后通过MRI评估共27个病灶，其中92.6%（25/27）的病灶在T1加权图像上具有高或稍高的信号强度，在T2加权图像上，77.8％（21/27）的病变具有混合信号强度。HIFU治疗前后AWE病灶的平均ADC值分别为1.47（1.20-1.59）×10-3mm2/s和1.86（1.61-2.12）×10-3mm2/s（P<0.05）。消融率高（>50%）的患者完全/部分缓解率高于消融率低（<50%）的患者。复发率较低(P<0.05)。
结论：MRI是识别位置的有用工具，尺寸,以及USg-HIFU治疗前后AWE的同时变化，这有利于后续监测和确定治疗效果。
方法：在USg-HIFU前后进行磁共振成像。有关患者临床特征的信息，病变的MRI特征,并收集治疗结果.29例患者在HIFU治疗前检查了30个AWE病灶，治疗后对27例患者进行了检查。术前MRI和彩色多普勒超声检查结果,比较了USg-HIFU治疗前后病灶的体积和表观扩散系数(ADC)值.我们还观察到临床症状缓解，复发,HIFU治疗后随访病灶的消融率。
结果：在USg-HIFU治疗前通过MRI确定30个AWE病灶的位置。MRI显示其大小大于超声检查（P<0.05）。USg-HIFU治疗后通过MRI评估共27个病灶，其中92.6%（25/27）的病灶在T1加权图像上具有高或稍高的信号强度，在T2加权图像上，77.8％（21/27）的病变具有混合信号强度。HIFU治疗前后AWE病灶的平均ADC值分别为1.47（1.20-1.59）×10-3mm2/s和1.86（1.61-2.12）×10-3mm2/s（P<0.05）。消融率高（>50%）的患者完全/部分缓解率高于消融率低（<50%）的患者。复发率较低(P<0.05)。
结论：MRI是识别位置的有用工具，尺寸,以及USg-HIFU治疗前后AWE的同时变化，这有利于后续监测和确定治疗效果。
