- 저자 : Yeo SY, Kim YS(주저자 : 김영선), Lim HK, Rhim H, Jung SH, Hwang NY - 영문 제목 : Uterine fibroids; Influence of “T2-rim sign” on immediate therapeutic responses to magnetic resonance imaging-guided high-intensity focused ultrasound ablation. - 한글 제목 : 자궁근종에 대한 MR하이푸 치료 시 "T2-테두리 싸인"이 치료효과에 미치는 영향 분석 - 저널 : Eur J Radiol - 연도 : 2017 - 권 / 쪽 : 97 / 21-30 - 초록
OBJECTIVES: To investigate the influence of a high-signal-intensity peripheral rim on T2-weighted MR images (i.e., T2-rim sign) on the immediate therapeutic responses of MR-guided high intensity focused ultrasound (MR-HIFU) ablation of uterine fibroids.
METHODS: This retrospective study was approved by the institutional review board, and patient informed consent was obtained for MR-HIFU ablation. In total, 196 fibroids (diameter 6.2±2.6cm) in 123 women (age 43.4±5.0 years) who underwent MR-HIFU ablation from January 2013 to April 2016 were included. The effects of a T2-rim sign on the immediate therapeutic responses (non-perfused volume [NPV] ratio, ablation efficiency [NPV/treatment cell volume], ablation quality [grade 1-5, poor to excellent]) were investigated with univariable and multivariable analyses using generalized estimating equation (GEE) analysis. In multivariable analysis, T2 signal intensity ratio of fibroids-to-skeletal muscle, relative peak enhancement of fibroids, and subcutaneous fat thickness were also considered.
RESULTS: The presence of a T2-rim sign significantly lowered the NPV ratio (54.0±28.0% vs. 83.7±17.7%), ablation efficiency (0.6±0.5 vs. 1.3±0.6), ablation quality (3.1±1.2 vs. 4.2±0.8), (P<0.0001). GEE analysis showed that the presence of a T2-rim sign was independently significant for ablation efficiency and ablation quality (P<0.05).
CONCLUSION: Uterine fibroids with a T2-rim sign showed significantly poorer immediate therapeutic responses to MR-HIFU ablation.