State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
Int J Hyperthermia. 2021;38(1):1341-1348. doi: 10.1080/02656736.2021.1973585.
To assess the long-term outcomes and the factors affecting local recurrence of uterine fibroids after ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation.
629 patients with a solitary uterine fibroid smaller than 10 cm in diameter treated with USgHIFU at our institutes between January 2011 and December 2016 were retrospectively analyzed. The patients were requested to take pre-HIFU and one day post-HIFU MRI. The patients were asked to return to the hospital every 3 months until January 2020, for imaging evaluation and to check on improvement in symptoms.
Five hundred and thirty-six patients completed follow-up according to our protocol. The median follow-up time was 69 (interquartile range: 48 to 89) months. Among them, local recurrence was detected in 110 patients. 18 (16.4%) patients required additional treatment between 12 and 24 months after USgHIFU treatment, 59 (53.6%) patients required additional treatment 24 months after USgHIFU. Therefore, in total, 77 patients required additional treatment, of which 32 received USgHIFU and 45 underwent myomectomy. The median non-perfused volume (NPV) ratio in patients with recurrence was 73%, compared to 89% among patients without recurrence. Multivariate analysis showed that NPV ratio, maximum fibroid diameter and fibroid enhancement type were the independent factors affecting the recurrence of fibroids after USgHIFU treatment.
Achievement of NPV ratio higher than 70% has led to acceptable re-intervention rate during the follow-up period after USgHIFU. NPV ratio, maximum fibroid diameter, and fibroid enhancement type were the independent factors affecting the recurrence of fibroids after USgHIFU treatment.
评估超声引导高强度聚焦超声（USgHIFU）消融治疗后子宫肌瘤的长期疗效及影响局部复发的因素。
回顾性分析 2011 年 1 月至 2016 年 12 月在我院接受 USgHIFU 治疗的 629 例直径小于 10cm 的单发子宫肌瘤患者。患者在 HIFU 术前及术后 1 天均行 MRI 检查。患者每 3 个月返回医院进行影像学评估和症状改善情况检查，直至 2020 年 1 月。
536 例患者按方案完成随访。中位随访时间为 69（四分位间距：4889）个月。其中 110 例患者发现局部复发。18（16.4%）例患者在 USgHIFU 治疗后 1224 个月需要额外治疗，59（53.6%）例患者在 USgHIFU 治疗后 24 个月需要额外治疗。因此，共有 77 例患者需要额外治疗，其中 32 例行 USgHIFU 治疗，45 例行子宫肌瘤切除术。复发患者的未增强体积（NPV）比值中位数为 73%，而无复发患者的 NPV 比值中位数为 89%。多因素分析显示，NPV 比值、最大肌瘤直径和肌瘤强化类型是影响 USgHIFU 治疗后肌瘤复发的独立因素。
在 USgHIFU 治疗后随访期间，NPV 比值大于 70%可获得可接受的再介入率。NPV 比值、最大肌瘤直径和肌瘤强化类型是影响 USgHIFU 治疗后肌瘤复发的独立因素。
