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• Clinical Article •
Evaluation of DWI on the early therapeutic efficacy of HIFU in adenomyosis
TANG Mingmei  WANG Lu  ZHANG Ke  PAN Yuanrui  LIU Hui  LÜ Fajin 

Cite this article as: TANG M M, WANG L, ZHANG K, et al. Evaluation of DWI on the immediate therapeutic efficacy of HIFU in adenomyosis[J]. Chin J Magn Reson Imaging, 2023, 14(12): 66-71. DOI:10.12015/issn.1674-8034.2023.12.011.


[Abstract] Objective To explore the value of diffusion weighted imaging (DWI) for evaluating the early therapeutic efficacy of high intensity focused ultrasound (HIFU) in treating adenomyosis.Materials and Methods The clinical and imaging data of 82 patients underwent HIFU treatment for adenomyosis were retrospectively analyzed. Contrast enhanced MRI (CE-MRI) with DWI were performed before treatment and within 48 hours post-treatment. DWI signal performance and change of ADC values of post-operative lesions were observed. The morphology of DWI signal change areas was evaluated and classified into three types: type I, spot-like or no obvious signal change; type Ⅱ, patchy signal change; type Ⅲ, ring-like signal change. The volume of DWI signal change areas and the nonperfused volume (NPV) on CE-MRI were evaluated and the difference and correlation between them were analyzed.Results DWI showed that there were 3 cases of type I, 4 cases of type Ⅱ, and 75 cases of type Ⅲ in the signal change areas of the necrotic lesions, and the kappa value of inter-observer reliability reached 0.848 (P＜0.001). The volume of DWI signal variation zones was 41.24 (25.63, 85.21) cm³, and the statistical analysis revealed no significant difference in the inter-observer reliability (P=0.581). The NPV on CE-MRI was 41.71 (20.72, 87.03) cm³, which was not statistically significant difference in the concordance with the volume of signal change areas on DWI (P=0.932), and there was a significant positive correlation between them (r=0.975, P＜0.001). Whether the ablated necrotic area on DWI showed complete or incomplete signal ring, the volume measured on DWI was not significantly different from the NPV (P＞0.05). The post-operative ADC values were significantly higher compared with the pre-operative values (P＜0.001).Conclusions DWI can effectively evaluate the early ablation effect of adenomyosis after HIFU, and it can make a reliable qualitative and quantitative evaluation of the occurrence and scope of ablation lesions.
[Keywords] adenomyosis；high intensity focused ultrasound；diffusion weighted imaging；magnetic resonance imaging；nonperfused volume

TANG Mingmei1, 2   WANG Lu1, 2   ZHANG Ke1, 2   PAN Yuanrui1, 2   LIU Hui1, 2   LÜ Fajin1, 3*  

1 State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China

2 Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China

3 Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

Corresponding author: LÜ F J, E-mail: fajinlv@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Foundation of State Key Laboratory of Ultrasound in Medicine and Engineering (No. 2022KFKT005).
Received  2023-09-07
Accepted  2023-12-07
DOI: 10.12015/issn.1674-8034.2023.12.011
Cite this article as: TANG M M, WANG L, ZHANG K, et al. Evaluation of DWI on the immediate therapeutic efficacy of HIFU in adenomyosis[J]. Chin J Magn Reson Imaging, 2023, 14(12): 66-71. DOI:10.12015/issn.1674-8034.2023.12.011.

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