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目的评估MRI对高强度聚焦超声(highintensityfocusedultrasound,HIFU)治疗骨肉瘤疗效随访的价值。方法前瞻性分析了经病理证实的16例骨肉瘤在HIFU治疗前后的MR平扫和多时相动态增强表现与诊断,并与99m锝-亚甲基二磷酸盐(99mTc-MDP)静态骨显像对照。结果MRI可正确判断14例骨肉瘤在HIFU治疗后的疗效。HIFU治疗前,16例骨肉瘤在T1WI上呈低信号、T2WI为混杂高信号,多时相动态扫描各期明显强化,99mTc-MDP骨显像显示瘤灶放射性异常浓聚。HIFU治疗后1~4周,瘤灶在T1WI上呈稍高信号、多时相动态扫描各期无强化、灭活区边缘见1条薄的强化带;99mTc-MDP骨显像显示瘤灶的放射性异常浓聚消失。HIFU治疗后3~25个月,瘤灶逐渐缩小,T2WI上的信号缓慢下降。结论HIFU是一种有效局部治疗骨肉瘤的方法,MRI能准确评估HIFU治疗骨肉瘤的疗效。
Objective To assess the value of MRI in the follow-up of high intensity focused ultrasound (HIFU) treatment of osteosarcoma. Methods Prospectively analyzed 16 cases of osteosarcoma confirmed by pathology before and after HIFU treatment. MR imaging and multi-phase dynamic contrast-enhanced manifestations and diagnostic results were compared with 99m Tc-MDP static bone imaging Control. Results MRI can correctly judge the effect of 14 cases of osteosarcoma after HIFU treatment. Before HIFU treatment, 16 cases of osteosarcoma showed low signal on T1WI, T2WI was mixed high signal, multi-phase dynamic scanning significantly enhanced at each stage, 99mTc-MDP bone imaging showed abnormal concentration of tumor focus. At 1 to 4 weeks after HIFU treatment, the lesion showed a slightly higher signal on T1WI, no enhancement in the multiphase dynamic scan, and a thin enhancement zone at the edge of the inactivated area. 99mTc-MDP bone imaging showed tumor radioactivity Abnormal concentration disappeared. After 3 to 25 months after HIFU treatment, the tumor gradually shrinks and the signal on T2WI slowly decreases. Conclusion HIFU is an effective method of local treatment of osteosarcoma. MRI can accurately evaluate the therapeutic effect of HIFU on osteosarcoma.