Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central South University, Changsha, China.
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.
Ultrasound Med Biol. 2023 Nov;49(11):2378-2387. doi: 10.1016/j.ultrasmedbio.2023.08.001. Epub 2023 Aug 17.
The aim of the work described here was to explore the clinical efficacy and safety of ultrasound-guided high-intensity focused ultrasound (USg-HIFU) treatment in women with multiple fibroids and identify the characteristic parameters predicting USg-HIFU efficacy in multiple fibroids.
From February 2021 to August 2022, 138 patients with multiple fibroids (group A comprising 125 patients with two to four fibroids and 13 patients with five or more fibroids) and 149 patients with solitary fibroids (group B) were included. HIFU treatment information, efficacy comparisons and adverse events were recorded. A nomogram model of the characteristic parameters used to predict the efficacy of USg-HIFU in multiple fibroids was established.
After USg-HIFU treatment, the statistical comparison of pre-operative versus post-operative symptom scores and fibroid volume in the two groups indicated obvious symptom relief and substantial shrinkage of fibroid volume (all p values <0.001). Nevertheless, group A required more energy and longer treatment and sonication times to achieve a 70% non-perfused volume (NPV) ratio, and had a lower energy efficiency factor than group B (all p values <0.05). No severe complications were observed in either group. The nomogram model included fibroid volume, fibroid location and signal intensity on T2-weighted imaging (T2WI). The area under the receiver operating characteristic curve and the accuracy of the model were 0.698 and 0.686, respectively.
USg-HIFU appears to be an effective and safe treatment option for multiple fibroids. Knowledge of the fibroid volume, location and signal intensity on T2WI may help determine the efficacy of USg-HIFU in multiple fibroids.
本研究旨在探讨超声引导高强度聚焦超声（USg-HIFU）治疗多发性子宫肌瘤的临床疗效和安全性，并确定预测多发性子宫肌瘤 USg-HIFU 疗效的特征参数。
回顾性分析 2021 年 2 月至 2022 年 8 月在我院行 HIFU 治疗的 138 例多发性子宫肌瘤患者（A 组包括 125 例 2~4 个肌瘤和 13 例 5 个及以上肌瘤）和 149 例单发子宫肌瘤患者（B 组）的临床资料，记录 HIFU 治疗信息、疗效比较和不良反应。建立预测 USg-HIFU 治疗多发性子宫肌瘤疗效的特征参数列线图模型。
两组患者治疗后症状评分和肌瘤体积均较术前明显下降（均 P<0.001），但 A 组达到 70%非增强体积（NPV）所需能量和治疗及超声时间均多于 B 组，能量效率因子低于 B 组（均 P<0.05）。两组均无严重并发症发生。列线图模型包括肌瘤体积、位置和 T2 加权成像（T2WI）信号强度。ROC 曲线下面积和模型准确性分别为 0.698 和 0.686。
USg-HIFU 治疗多发性子宫肌瘤安全有效，肌瘤体积、位置和 T2WI 信号强度可能有助于预测多发性子宫肌瘤的 USg-HIFU 疗效。
