Fröling V, Kröncke T J, Schreiter N F, Scheurig-Muenkler C, Collettini F, Hamm B, Beck A
Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany,
Cardiovasc Intervent Radiol. 2014 Apr;37(2):445-50. doi: 10.1007/s00270-013-0678-z. Epub 2013 Jul 10.
This study was designed to evaluate the technical eligibility for magnetic resonance-guided focused ultrasound surgery (MRgFUS) treatment of women with symptomatic fibroids.
Technical eligibility for MRgFUS treatment without mitigation techniques was evaluated retrospectively in 783 premenopausal women (median age, 44.2 years) with symptomatic fibroids who applied for uterine artery embolization (UAE) at our institution from 2001 to 2012. Technical eligibility for MRgFUS was defined as primary study endpoint. Technical ineligibility was assessed on the basis of MRI criteria, such as bowel interposition/foreign material in the ultrasound beam path, more than five fibroids, distance from fibroid to sacral bone surface, fibroid size/shape, severe concomitant adenomyosis or extensive cutaneous scars in accordance to the US Food and Drug Administration approvals. Secondary study endpoint was defined as evaluation of the most frequent exclusion criteria and differences in technical eligibility for MRgFUS and UAE.
On the basis of MRI, 38.9% of women who applied for UAE were found to be technically eligible for MRgFUS treatment without mitigation techniques. Most frequent reason for ineligibility was bowel interposition in the ultrasound beam path (60.4%). Differences in technical eligibility for MRgFUS (38.9%) and UAE (99.2%) were significant (P < 0.001).
MRgFUS treatment is technically possible in up to 40% of women with symptomatic fibroids. The most frequent exclusion criterion is the presence of bowel in the ultrasound beam path.
本研究旨在评估磁共振引导聚焦超声手术（MRgFUS）治疗有症状子宫肌瘤女性的技术适用性。
对2001年至2012年在本机构申请子宫动脉栓塞术（UAE）的783例有症状子宫肌瘤的绝经前女性（中位年龄44.2岁）进行回顾性评估，以确定其在不采用缓解技术情况下接受MRgFUS治疗的技术适用性。将MRgFUS的技术适用性定义为主要研究终点。根据美国食品药品监督管理局的批准，依据MRI标准评估技术不适用性，如超声束路径中有肠管介入/异物、肌瘤超过5个、肌瘤到骶骨表面的距离、肌瘤大小/形状、严重的合并子宫腺肌病或广泛的皮肤瘢痕。次要研究终点定义为评估最常见的排除标准以及MRgFUS和UAE技术适用性的差异。
基于MRI，发现38.9%申请UAE的女性在不采用缓解技术的情况下技术上适合接受MRgFUS治疗。最常见的不适合原因是超声束路径中有肠管介入（60.4%）。MRgFUS（38.9%）和UAE（99.2%）技术适用性的差异具有统计学意义（P < 0.001）。
对于高达40%有症状子宫肌瘤的女性，MRgFUS治疗在技术上是可行的。最常见的排除标准是超声束路径中有肠管存在。
