中文摘要：

目的：通过多普勒超声观察高强度聚焦超声（HIFU）治疗子宫肌瘤滋养血管血流动力学变化，探讨其在疗效评价方面的应用价值。方法：HIFU治疗子宫单发肌壁间肌瘤30例，分别于HIFU术前、术后即刻、1个月及3个月行超声检查，比较肌瘤周边滋养血管和子宫动脉PI及RI变化，并将术后3个月体积变化与其进行相关分析。结果：术后1月及3个月肌瘤体积分别由术前的（40．92±28．58）cm^2降至（27．48±16．92）cm^3（P〈0．001）和（15．57±17．72）cm^3（P〈0．0001），肌瘤HIFU术后即刻周边滋养血管RT增高（P〈0．05），术后3个月滋养血管RI较1个月增高（P〈0．01），术后1个月周边滋养血管PI增高（P〈0．05），HIFU术后即刻较术前，术后3个月较1个月子宫动脉RI增高（P〈0．001），PI增高不明显（P〉0．05）。子宫肌瘤HIFU术后1个月周边滋养血管RI增加率与术后3个月体积缩小率呈正相关（r=0．42），术后3个月周边滋养血管RI增加率与之呈正相关（r=0．33）。结论：多普勒超声检测HIFU术后1月肌瘤周边滋养血管RI是预测早期疗效的有效手段。

英文摘要：

Objective： To observe the hemodynamic changes in trophoblast vessels of uterine fibroids with the doppler ultrasound and to explore the practical value of doppler ultrasound in evaluating the efficacy of HIFU ablation therapy for uterine fibroids. Methods： Thirty patients with haplo-intramural fibroids, aged 29-48, were treated with HIFU. Doppler ultrasound was used to observe PI and RI changes of the uterine artery and trophoblast vessels of uterine fibroids before HIFU treatment, immediately after the treatment, 1 month after the treatment and 3 months after the treatment. Analyses were performed to compare the increase with the reduction of fibroid volume at 3 months after HIFU treatment. Results： At 1 month after HIFU treatment, the fibroid volume was reduced from 40.92±28.58cm^3 to 27.48±16.92cm^3 （P〈0.001）. At 3 months after the treatment, the fibroid volume was reduced to 15.57±17.72cm^3 （P〈0.0001）. Immediately after HIFU treatment, RI of the trophoblast vessels of uterine fibroids was increased （P〈0.05）. At 3 months after the treatment, Rl of the trophoblast vessels of uterine fibroids was higher than that at 1 month after the treatment （P〈0.01）. At 1 month after the treatment, PI of the trophoblast vessels of uterine fibroids was increased （P〈0.05）. Immediately after the treatment, RI of the uterine artery was higher than that before the treatment. At 3 months after the treatment, RI of the uterine artery was higher than that at 1 month after the treatment （P〈0.001）. PI of the uterine artery was increased inconspicuously. At 1 month after the HIFU treatment, the increasing rate of RI of the trophoblast vessels of uterine fibroids was positively correlated with the reduction ratio of the volume of artery （r=0.42）. At 3 months after HIFU treatment, the increasing rate of RI of the trophoblast vessels of uterine fibroids was positively correlated with the reduction ratio of the volume of artery （r= 0.33）. Conclusion： Doppler ultrasound is an effective w