【摘要】 目的 观察三维能量多普勒超声（3D-PDUS）血管参数定量评估子宫肌瘤高强度聚焦超声（HIFU）消融效果的价值。方法 纳入HIFU消融治疗的子宫肌瘤67个，根据磁共振T₁加权成像（MRI T₁WI）增强肌瘤强化程度分为轻度强化组与明显强化组，进行3D-PDUS扫查获取肌瘤体积及血管参数[血管指数（VI）、血流指数（FI）、血管化血流指数（VFI）],并计算HIFU消融后VI、FI、VFI下降率，比较组间差异、消融前后的变化情况以及与HIFU消融效果的相关性。结果 MRI T₁WI强化程度越高，VI及VFI越高，消融后VI、FI、VFI均降低，P<0.05。轻度强化组中，肌瘤体积与HIFU消融率及能效因子（EEF）相关性较高，明显强化组中，VI、FI、VFI下降率与HIFU消融率及EEF显著相关，高消融肌瘤（消融率≥70%）的VI、FI、VFI下降率高于低消融肌瘤（消融率<70%）,P<0.05。结论 3D-PDUS血管参数能够定量评估子宫肌瘤HIFU消融前后的血流变化情况，肌瘤体积及VI、FI、VFI下降率与HIFU消融效果存在相关性，3D-PDUS评估子宫肌瘤HIFU消融效果有一定价值。更多还原

【Abstract】 Objective To observe the value of using three-dimensional power Doppler ultrasound（3D-PDUS） vascular parameters in the quantitative assessment of the efficacy of high-intensity focused ultrasound（HIFU） ablation for hysteromyoma. Methods Sixty-seven hysteromyomas treated with HIFU ablation were included in the study. The hysteromyomas were categorized into two groups based on the degree of enhancement on magnetic resonance T₁-weighted imaging（ MRI T₁WI）: a mild enhancement group and a significant enhancement group. 3D-PDUS was used to scan the hysteromyoma, obtaining hysteromyoma volume and vascular parameters [vascularization index（VI）, flow index（FI）, vascularization-flow index（VFI）]. The reduction rates of VI, FI, and VFI after ablation were calculated. Differences between the groups, changes before and after HIFU ablation, and the correlation with HIFU ablation efficacy were compared. Results The higher the enhancement on MRI T₁WI, the higher the VI and VFI. After HIFU ablation, VI, FI, and VFI all decreased, with P<0.05. In the mild enhancement group, hysteromyoma volume had a higher correlation with HIFU ablation rate and energy efficiency factor（EEF）. In the significant enhancement group, the reduction rates of VI, FI, and VFI were significantly correlated with HIFU ablation rate and EEF. The reduction rates of VI, FI, and VFI in high-ablation hysteromyoma（ablation rate ≥70%） were higher than those in low-ablation hysteromyoma（ablation rate <70%）, with P<0.05. Conclusions 3D-PDUS vascular parameters can quantitatively assess the changes in blood perfusion before and after HIFU ablation of hysteromyoma. The reduction rates of hysteromyoma volume, VI, FI, and VFI are correlated with HIFU ablation efficacy, suggesting that 3D-PDUS has a certain value in evaluating the efficacy of HIFU ablation for hysteromyoma.更多还原