HIFU 消融治疗 NPVR≥90%子宫肌瘤的耐受性和疗效：一项巢式病例对照研究。

Tolerance and efficacy of HIFU ablation for uterine fibroids NPVR ≥ 90%: a nested case-control study.

机构信息

State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.

College of Medical Informatics, Chongqing Medical University, Chongqing, China.

出版信息

Int J Hyperthermia. 2022;39(1):946-951. doi: 10.1080/02656736.2022.2093414.

DOI:10.1080/02656736.2022.2093414

PMID:35853723

Abstract

OBJECTIVE

To investigate the tolerance and efficacy of HIFU ablation for uterine fibroids with a non-perfused volume ratio (NPVR) ≥ 90%.

METHODS

A prospective cohort study of 2411 patients from 20 clinical centers was available. Contrast-enhanced MRI was used to assess the non-perfused volume ratio (NPVR). The International Society of Interventional Radiotherapy (SIR) complication grading system was used as the tolerance index. Uterine Fibroids-related Symptoms-Quality of Life (UFS-QoL) was used to evaluate the efficacy.

RESULTS

A total of 1352 patients underwent USgHIFU ablation treatment enrolled, NPVR was median 91.9% (IQR, 81.4%,100.0%). There was 761 case (56.3%) in the NPVR ≥ 90% group in which 17.5% case experienced SIR-B abdominal pain, 591 cases (43.7%) in NPVR < 90% group in which 9.3% case had SIR-B abdominal pain. There were statistically differences in the improvement degree of UFS at 12 months among the four subgroups (NPVR < 70%, 70%-80%, 80%-90%, 90%-100%) (all < 0.05).

CONCLUSIONS

Patients with NPVR ≥ 90% had a higher incidence of SIR-B lower abdominal pain. NPVR was positively correlated with the degree of symptom relief at 12 months, and NPVR ≥ 90% was more likely to obtain better clinical symptom relief.

摘要

目的

探讨非灌注体积比（NPVR）≥90%的子宫肌瘤患者接受 HIFU 消融治疗的耐受性和疗效。

方法

本研究为 20 个临床中心的 2411 例患者的前瞻性队列研究。采用增强 MRI 评估非灌注体积比（NPVR）。采用国际介入放射治疗学会（SIR）并发症分级系统作为耐受指数。采用子宫肌瘤相关症状生活质量（UFS-QoL）量表评估疗效。

结果

共纳入 1352 例行 USgHIFU 消融治疗的患者，NPVR 中位数为 91.9%（IQR，81.4%，100.0%）。NPVR≥90%组 761 例（56.3%）中有 17.5%发生 SIR-B 级腹痛，NPVR<90%组 591 例（43.7%）中有 9.3%发生 SIR-B 级腹痛。四个亚组（NPVR<70%、70%-80%、80%-90%、90%-100%）在 12 个月时 UFS 改善程度存在统计学差异（均 P<0.05）。