School of Medicine, Anhui University of Science and Technology, Huainan Anhui, China.
Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.
Br J Radiol. 2022 Sep 1;95(1137):20220039. doi: 10.1259/bjr.20220039. Epub 2022 Jul 5.
To investigate the mid-term local treatment efficiency of ultrasound-guided percutaneous microwave ablation (MWA) for uterine fibroids (UFs) and the associated influencing factors.
From July 2020 to October 2021, a total of 28 patients with 52 UFs who had undergone ultrasound-guided MWA were retrospectively included in this study. Pre-treatment clinical characteristics, conventional ultrasound and contrast-enhanced ultrasound (CEUS) features were analyzed to explore their correlation with volume reduction ratios (VRRs) of sufficient ablation ( a VRR of at least 50% at the 3 month follow-up). The patients were assessed at 1-, 3-, 6 month follow-up after MWA treatment and the assessment included VRR, adverse events, uterine fibroid symptom (UFS) and quality of life (QoL) scores, and clinical symptoms.
The procedures of percutaneous MWA for UFs were tolerated well and no major complications occurred in all patients. At the 1-, 3-, 6 month follow-up, the median VRRs of UFs were 30.1%, 46.9%, and 65.8%, respectively. At the 3 month follow-up, 44.4% of fibroids obtained sufficient ablation while the remaining 55.6% obtained partial ablation ( a VRR of <50%). Non-enhancing area during the early phase ( within 30 s after injecting contrast agent) on pre-treatment CEUS was present in 22.2% UFs, which was associated with sufficient ablation at the 3 month follow-up ( < 0.05). In addition, the relevant clinical symptoms of all patients were alleviated or removed. The UFS and QoL score after MWA decreased significantly in comparison with those after MWA ( = 0.04 and = 0.057, respectively), indicating a remarkable improvement of clinical symptom and QoL.
Ultrasound-guided MWA is an effective and safe method to treat patients with UFs. Non-enhancing area during the early phase on pretreatment CEUS is associated with mid-term local treatment efficiency, which might be used to predict treatment outcome.
Non-enhancing area during the early phase on pretreatment CEUS is an important factor associated with mid-term local treatment efficiency. This is the first study finding that CEUS feature can be used as a marker for the prediction of mid-term local treatment response.
探讨超声引导下经皮微波消融（MWA）治疗子宫肌瘤（UFs）的中期局部疗效及其相关影响因素。
回顾性分析 2020 年 7 月至 2021 年 10 月期间 28 例 52 个 UFs 患者行超声引导下 MWA 的临床资料。分析患者术前临床特征、常规超声及超声造影（CEUS）特征，探讨其与消融充分的体积缩小率（VRR）（至少 50%的 VRR 在 3 个月随访时）的相关性。所有患者均在 MWA 治疗后 1、3、6 个月进行评估，评估内容包括 VRR、不良事件、子宫肌瘤症状（UFS）和生活质量（QoL）评分以及临床症状。
所有患者均能耐受经皮 MWA 治疗，且无严重并发症发生。在 1、3、6 个月的随访中，UFs 的中位 VRR 分别为 30.1%、46.9%和 65.8%。在 3 个月的随访中，44.4%的肌瘤获得了充分消融，而其余 55.6%的肌瘤获得了部分消融（VRR<50%）。术前 CEUS 早期（造影剂注射后 30s 内）无增强区见于 22.2%的 UFs，与 3 个月时的充分消融有关（<0.05）。此外，所有患者的相关临床症状均得到缓解或消除。与 MWA 后相比，UFS 和 QoL 评分在 MWA 后明显降低（=0.04 和=0.057），表明临床症状和 QoL 有显著改善。
超声引导下 MWA 是治疗 UFs 患者的一种有效且安全的方法。术前 CEUS 早期无增强区与中期局部疗效相关，可用于预测治疗效果。
术前 CEUS 早期无增强区是与中期局部疗效相关的重要因素。这是首次发现 CEUS 特征可作为预测中期局部治疗反应的标志物。
