Xue Hailan, Wu Songsong, Xiao Kunhong, Ding Guisheng, Chen Sheng
Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
Front Oncol. 2024 Aug 16;14:1451626. doi: 10.3389/fonc.2024.1451626. eCollection 2024.
This study aimed to identify the sonographic indicators that predict the ablation rate and efficiency of uterine fibroids during high-intensity focused ultrasound (HIFU) treatment.
In this retrospective study, we analyzed the clinical data of patients with uterine fibroids who underwent HIFU treatment at Fujian Provincial Hospital between April 2019 and April 2022. Routine abdominal ultrasound examinations were performed to observe potential indicators before the HIFU treatment. After the treatment, enhanced magnetic resonance imaging (MRI) examination was performed within 2 weeks. The fibroid and non-perfused volumes (NPV) were determined, and the ablation rate and energy efficiency factor (EEF) were calculated.
A total of 75 patients (124 uterine fibroids) were included in this study. Uterine fibroids with a larger volume, high echogenicity, elliptical/diffuse leaf shape, and a posterior attenuation band had a higher HIFU ablation rate (<0.05). Uterine fibroids with a larger volume and high echogenicity and without necrotic areas had a lower EEF (<0.05). Multiple comparisons between fibroid types revealed statistically significant differences in EEF between subserosal and submucosal fibroids < 0.05) and between subserosal and mixed-type fibroids ( < 0.05). However, no statistically significant difference was observed between mixed-type and submucosal fibroids. The HIFU ablation rate and EEF showed no significant differences based on location within the wall and blood flow within the fibroids.
Sonographic features of uterine fibroids can predict the rate and efficiency of HIFU ablation, providing useful guidance in selecting appropriate treatment for patients.
本研究旨在确定在高强度聚焦超声（HIFU）治疗期间预测子宫肌瘤消融率和效率的超声指标。
在这项回顾性研究中，我们分析了2019年4月至2022年4月在福建省立医院接受HIFU治疗的子宫肌瘤患者的临床资料。在HIFU治疗前进行常规腹部超声检查以观察潜在指标。治疗后，在2周内进行增强磁共振成像（MRI）检查。确定肌瘤和无灌注体积（NPV），并计算消融率和能量效率因子（EEF）。
本研究共纳入75例患者（124个子宫肌瘤）。体积较大、高回声、椭圆形/弥漫性叶状且有后方衰减带的子宫肌瘤具有较高的HIFU消融率（<0.05）。体积较大、高回声且无坏死区域的子宫肌瘤EEF较低（<0.05）。肌瘤类型之间的多重比较显示，浆膜下肌瘤与黏膜下肌瘤之间（<0.05）以及浆膜下肌瘤与混合型肌瘤之间（<0.05）的EEF存在统计学显著差异。然而，混合型肌瘤与黏膜下肌瘤之间未观察到统计学显著差异。基于肌瘤在子宫壁内的位置和肌瘤内的血流情况，HIFU消融率和EEF无显著差异。
子宫肌瘤的超声特征可预测HIFU消融的速率和效率，为为患者选择合适的治疗提供有用的指导。
