Magnetic resonance imaging evaluation and analysis of influencing factors of early uterine seromuscular layer injury after high-intensity focused ultrasound ablation of uterine fibroids.

BACKGROUND

High-intensity focused ultrasound (HIFU) is being used more frequently to treat uterine fibroids, with many researchers conducting studies on efficacy prediction and evaluation. However, research related to seromuscular layer injury is limited. Therefore, this study aimed to identify the factors contributing to seromuscular layer injury following HIFU ablation of uterine fibroids, using magnetic resonance imaging (MRI) as the evaluation tool.

METHODS

A retrospective cross-sectional study was conducted, involving imaging data from 194 patients diagnosed and treated with HIFU ablation for uterine fibroids at our institution. Patients were divided into the seromuscular-layer injury group and the intact group based on the presence or absence of perfusion defects on postoperative sagittal or axial enhanced T1-weighted imaging (T1WI) magnetic resonance images. Clinical and imaging traits potentially linked to seromuscular-layer injury were gathered and evaluated across the two groups.

RESULTS

The intact group comprised 139 cases, whereas the injury group comprised 55 cases. Logistic regression analysis revealed that subserous myoma (P=0.008), age ≤43.5 years (P=0.008), the thickness of the rectus abdominis muscle ≤8.06 mm (P=0.001), the energy efficiency factor ≤3.6 J/mm (P=0.002), the non-perfused volume ratio ≥67% (P=0.032), and the number of quadrants of peripheral muscle layer ≤1 (P=0.015) were the most significant influencing factors for seromuscular-layer injury in patients with uterine fibroids after HIFU treatment.

CONCLUSIONS

There is a possibility of seromuscular-layer injury after using HIFU to treat uterine fibroids, and MRI plays an important role in the early diagnosis of seromuscular-layer injury. Studying the influencing factors of seromuscular-layer injury provides a reference basis for timely clinical intervention.