| BackgroundUterine myoma was a common benign tumor in the female reproductive system in 30-50 years old,which seriously affects the physical and mental health of the patients.Ultrasound ablation was a minimally invasive technique for the treatment of uterine leiomyoma in recent years,the key to success was to make the lesions of the uterine leiomyoma reach the satisfactory extent.MRI had a high density resolution for soft tissue,it was superior to CT and ultrasound in evaluating the curative effect of ultrasound ablation.The newly developed functional imaging method DTI could reflect the microscopic structure and pathological changes of different pathological types of uterine fibroids and their ablation.ObjectiveUsing the DTI technology,through the image postprocessing workstation,uterine fibroids uterine structure observation in different parts of the menstrual cycle,age,and different growth location,pathological type,signal intensity and after ultrasonic ablation of FA value,ADC value and the ablation rate changes,to provide an objective basis for the selection,evaluation and follow-up time points of ultrasound ablation for uterine fibroids.MethodsSelecting the period from January 2016 to December 2016 by DTI scan 240cases as normal women of childbearing age group,it was divided into 20-29 years old groups,30-39 years old group and 40-49 years old group,80 cases in each group,and each group according to the menstrual cycle menstrual period,ovulation period,proliferation,secretion of 20 cases in each period.Selecting the DTI scan in the diagnosis of uterine fibroids in women of reproductive age in 270 cases of 270myoma as study group in 20-49 years old,according to the growth site of uterine leiomyoma was divided into submucous myoma group,intramural myoma group and subserous myoma group,90 cases in each group,and each group according to the common type of leiomyoma type,pathological type and cell type,30 cases of degenerative fibroids,uterine fibroids MRI according to the T2 signal intensity was low,uniform signal group?the myoma group uniform low signal and uniform signal15 cases each?and homogeneous high signal group,uneven level of myoma group mixed signal myoma group with 30 cases in each group.The Chinese Chongqing type JC ultrasonic tumor therapy instrument and the American GE 1.5 T magnetic resonance apparatus were used.Using ADW 4.6 image post processing workstation software,the original data of DTI was processed after image processing to generate FA image,ADC image and fiber tracking image.The FA value,ADC value and volume of the region of interest in the uterine myoma and ultrasonic ablation area were measured on the workstation,and the ablation rate was calculated.The SPSS 19 statistical software was used to deal with the data,and the difference was statistically significant in P<0.05.Results1.The structure of normal uterine endometrium,combined and muscular layer of FA values and ADC values were?0.17±0.02?,?0.28±0.03?,?0.22±0.02?and?1.28±0.15?×10-3mm2/s,?1.01±0.12?×10-3mm2/s,?1.75±0.23?×10-3mm2/s respectively,between the three layers structure had significant difference?P<0.05?.There was no significant difference in the FA value and ADC value between the endometrium and the menstrual cycle and age?P<0.05?,there was no significant difference in the location,menstrual cycle,age of the combined band and muscle layer?P>0.05?.2.Mucosa in different growth parts of myoma of uterus myoma and intramural myoma,subserous myoma of the FA values and ADC values were?0.38±0.04?,?0.41±0.05?,?0.39±0.02?and?1.36±0.12?×10-3mm2/s,?1.32±0.13?×10-3mm2/s,?1.34±0.14?×10-33 mm2/s respectively,between the three growth sites showed no significant difference?P>0.05?.There were significant differences between different pathological types of common leiomyoma,myoma,leiomyoma and degenerative cell type different signal strength uniform low signal uniform signal myoma,leiomyoma,uneven homogeneous high signal of mixed signal myoma FA value and ADC value?P<0.05?,the FA value of common type and uniform low signal fibroids was the lowest and the highest ADC value,the FA value of cell type myoma and myoma of homogeneous high signal was the highest and the ADC value was the lowest.3.Myoma of uterus in different growth parts of submucosal myoma,intramural myoma,subserous myoma and different pathological types of common type of degeneration of myoma,leiomyoma,and different signal strength uniform low signal and uniform signal fibroids fibroids,uneven level mixed signal myoma after ultrasonic ablation ablation zone of FA values and ADC values decreased,and the ablation had significant difference?P<0.05?.The cell type myoma and myoma homogeneous high signal ultrasound ablation before and after FA values and ADC values were?0.57±0.05?,?0.53±0.05?and?0.56±0.05?,?0.54±0.06?,?1.01±0.13?×10-3mm2/s,?1.00±0.12?×10-3mm2/s and?1.01±0.14?×10-3mm2/s,?1.00±0.11?×10-3mm2/s respectively,it had no significant difference?P>0.05?.4.The ablation rates of submucous myoma,intramural myoma and subserous myoma at different growth sites of uterine fibroids were?65.72±5.84?%,?66.05±7.18?%,?65.93±5.44?%respectively,and there was no significant difference among three different growth sites?P>0.05?.There were significant differences in the ablation rate of three different pathological types and four different signal intensities of uterine fibroids?P<0.05?,the ablation rate of common myoma and homogeneous low signal myoma was the highest,and the ablation rate of cell type and homogeneous high myoma was the lowest.5.The level of mixed signal myoma after ablation in January was not uniform common type of degeneration of myoma and myoma,leiomyoma,uniform homogeneous low signal signal myoma,and 1 hours after surgery,24 hours and 1weeks after operation respectively,the FA values,ADC values and the ablation rate had significant difference?P<0.05?,there were no significant differences in FA value and ADC value in the June,March postoperative?P>0.05?.There was no significant difference in the time after the ablation of cell myoma and homogeneous hypersignal myoma?P>0.05?.Conclusion1.The FA value and ADC value of DTI could accurately and sensitively reflect the microscopic structure and pathological changes of uterine fibroids and their ultrasonic ablation area,it was an important imaging index of noninvasive evaluation of uterine fibroids and their effect of ultrasonic ablation.2.DTI could objectively evaluate different growth parts,pathological types and signal intensity of uterine fibroids and ablation rate,and improve the imaging evaluation value,to provide an objective basis for the selection,evaluation and follow-up time points of ultrasound ablation for uterine fibroids. |
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