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高强度聚焦超声消融治疗子宫肌瘤后患者的盆腹腔内筋膜肿胀的 MRI 评估及影响因素分析。

MRI evaluation of endopelvic fascial swelling and analysis of influencing factors in patients with uterine fibroids after high-intensity focused ultrasound ablation.

机构信息

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China.

Therapeutic Center of Ultrasound Ablation, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China.

出版信息

Int J Hyperthermia. 2020;37(1):175-181. doi: 10.1080/02656736.2019.1701100.

Abstract

To evaluate endopelvic fascial swelling in patients with uterine fibroids after high-intensity focused ultrasound (HIFU) ablation on magnetic resonance imaging (MRI) and investigate the factors that influence endopelvic fascial swelling. MRI and clinical data from 188 patients with uterine fibroids who were treated with HIFU were analyzed retrospectively. The patients were divided into a fascial swelling group and a non-swelling group, and the degree of swelling was graded. Fascial swelling was set as the dependent variable, and factors such as baseline characteristics and HIFU parameters, were set as the independent variables. The relationship between these variables and fascial swelling was analyzed by univariate and multivariate analyses. Correlations between the factors and the degree of fascial swelling were evaluated by Kruskal-Wallis test. The univariate analysis revealed that the fibroid location, distance from the fibroid to the sacrum, sonication time, treatment time, treatment intensity, therapeutic dose (TD), and energy efficiency (EEF) all affected the endopelvic fascial swelling ( < 0.05). Subsequently, multivariate analysis showed that the distance from the fibroid to the sacrum was significantly correlated with fascial swelling ( < 0.05). Moreover, TD and sonication time were significantly positively correlated with the degree of fascial swelling ( < 0.05). The incidence of sacrococcygeal pain was significantly correlated with fascial swelling ( < 0.05). The distance from the fibroid to the sacrum was a protective factor for fascial swelling. TD and sonication time were significantly positively correlated with the degree of fascial swelling.

摘要

评估高强度聚焦超声(HIFU)消融治疗子宫肌瘤后磁共振成像(MRI)上的盆筋膜肿胀,并探讨影响盆筋膜肿胀的因素。回顾性分析 188 例 HIFU 治疗子宫肌瘤患者的 MRI 和临床资料。将患者分为筋膜肿胀组和非肿胀组,并对肿胀程度进行分级。将筋膜肿胀设为因变量,将基线特征和 HIFU 参数等因素设为自变量。采用单因素和多因素分析分析这些变量与筋膜肿胀的关系。采用 Kruskal-Wallis 检验评估各因素与筋膜肿胀程度的相关性。单因素分析显示,肌瘤位置、肌瘤与骶骨的距离、超声时间、治疗时间、治疗强度、治疗剂量(TD)和能量效率(EEF)均影响盆筋膜肿胀( < 0.05)。随后,多因素分析显示,肌瘤与骶骨的距离与筋膜肿胀显著相关( < 0.05)。此外,TD 和超声时间与筋膜肿胀程度呈显著正相关( < 0.05)。尾骨疼痛的发生率与筋膜肿胀显著相关( < 0.05)。肌瘤与骶骨的距离是筋膜肿胀的保护因素。TD 和超声时间与筋膜肿胀程度呈显著正相关。

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