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磁共振成像引导聚焦超声手术治疗子宫肌瘤的生殖影响:证据的系统评价

Reproductive impact of MRI-guided focused ultrasound surgery for fibroids: a systematic review of the evidence.

作者信息

Clark Natalie A, Mumford Sunni L, Segars James H

机构信息

aDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan bEpidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development cProgram in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA.

出版信息

Curr Opin Obstet Gynecol. 2014 Jun;26(3):151-61. doi: 10.1097/GCO.0000000000000070.

DOI:10.1097/GCO.0000000000000070
PMID:24751998
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4137489/
Abstract

PURPOSE OF REVIEW

Magnetic-resonance-guided focused ultrasound surgery (MRgFUS) is a minimally invasive technique for the treatment of uterine fibroids. The purpose of this review is to highlight the impact of MRgFUS on fertility and reproductive outcomes.

RECENT FINDINGS

The role of MRgFUS in the treatment of fibroids has been evolving since its introduction in 2004. Several new devices and techniques including location-specific treatment, volumetric therapy, and vessel-targeted therapy have been introduced over the last few years. Several case series report uncomplicated pregnancy following MRgFUS; however, results of the ongoing studies will further elucidate the utility of MRgFUS in patients planning future fertility. A systematic review of the literature was completed and studies that reported quality of life at baseline and after 6 months were included in a meta-analysis.

SUMMARY

MRgFUS represents a minimally invasive treatment for uterine fibroids that is able to improve the quality of life and fibroid size with durability. It is possible that MRgFUS could be the treatment of choice for patients desiring future fertility; however, further investigation is needed.

摘要

综述目的

磁共振引导聚焦超声手术(MRgFUS)是一种治疗子宫肌瘤的微创技术。本综述的目的是强调MRgFUS对生育能力和生殖结局的影响。

最新发现

自2004年引入以来,MRgFUS在子宫肌瘤治疗中的作用一直在不断发展。在过去几年中,已经推出了几种新设备和技术,包括定位特异性治疗、容积治疗和血管靶向治疗。几个病例系列报告了MRgFUS后无并发症的妊娠情况;然而,正在进行的研究结果将进一步阐明MRgFUS在计划未来生育的患者中的效用。完成了对文献的系统综述,并将报告基线和6个月后生活质量的研究纳入荟萃分析。

总结

MRgFUS是一种能够持久改善生活质量和缩小肌瘤大小的子宫肌瘤微创治疗方法。对于希望未来生育的患者,MRgFUS有可能成为首选治疗方法;然而,还需要进一步研究。

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本文引用的文献

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Reprod Sci. 2014 Apr;21(4):465-76. doi: 10.1177/1933719113497289. Epub 2013 Jul 18.
2
Technical eligibility for treatment of magnetic resonance-guided focused ultrasound surgery.磁共振引导聚焦超声手术治疗的技术合格标准。
Cardiovasc Intervent Radiol. 2014 Apr;37(2):445-50. doi: 10.1007/s00270-013-0678-z. Epub 2013 Jul 10.
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Magnetic resonance imaging-guided focused ultrasound surgery for symptomatic uterine fibroids: estimation of treatment efficacy using thermal dose calculations.
Medicina (Kaunas). 2024 May 26;60(6):868. doi: 10.3390/medicina60060868.
4
A Systematic Review of Minimally Invasive Approaches to Uterine Fibroid Treatment for Improving Quality of Life and Fibroid-Associated Symptoms.经阴道子宫肌瘤剔除术治疗子宫肌瘤改善生活质量和肌瘤相关症状的系统评价。
Reprod Sci. 2023 May;30(5):1495-1505. doi: 10.1007/s43032-022-01120-9. Epub 2022 Nov 18.
5
Basics in Magnetic Resonance guided Focused Ultrasound: technical basis and clinical application. A brief overview.磁共振引导聚焦超声基础:技术基础和临床应用。简要概述。
Acta Biomed. 2021 Sep 10;92(S5):e2021403. doi: 10.23750/abm.v92iS5.11881.
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Adhesions after Laparoscopic Myomectomy: Incidence, Risk Factors, Complications, and Prevention.腹腔镜子宫肌瘤切除术后的粘连:发生率、危险因素、并发症及预防
Gynecol Minim Invasive Ther. 2020 Oct 15;9(4):190-197. doi: 10.4103/GMIT.GMIT_87_20. eCollection 2020 Oct-Dec.
7
Updated approaches for management of uterine fibroids.子宫肌瘤管理的更新方法。
Int J Womens Health. 2017 Sep 5;9:607-617. doi: 10.2147/IJWH.S138982. eCollection 2017.
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A clinical investigation treating different types of fibroids identified by MRI-T2WI imaging with ultrasound guided high intensity focused ultrasound.MRI-T2WI 成像引导下超声聚焦高强度治疗不同类型子宫肌瘤的临床研究。
Sci Rep. 2017 Sep 7;7(1):10812. doi: 10.1038/s41598-017-11486-5.
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Sci Rep. 2017 Jun 21;7(1):3977. doi: 10.1038/s41598-017-04319-y.
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Magnetic resonance imaging-guided focused ultrasound treatment of symptomatic uterine fibroids: impact of technology advancement on ablation volumes in 115 patients.磁共振引导聚焦超声治疗有症状的子宫肌瘤:技术进步对 115 例患者消融体积的影响。
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Feasibility of ultrasound-guided high intensity focused ultrasound ablating uterine fibroids with hyperintense on T2-weighted MR imaging.T2 加权磁共振成像高信号子宫肌瘤的超声引导高强度聚焦超声消融的可行性。
Eur J Radiol. 2013 Jan;82(1):e43-9. doi: 10.1016/j.ejrad.2012.08.020. Epub 2012 Sep 20.
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Clinical 24 month experience of the first MRgFUS unit for treatment of uterine fibroids in Australia.澳大利亚首台用于治疗子宫肌瘤的磁共振引导聚焦超声(MRgFUS)设备的24个月临床经验。
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