摘要
目的探讨高强度聚焦超声(HIFU)消融子宫肌瘤临床疗效,评估其影响因素。方法收集2016年5月至2019年1月经HIFU治疗的子宫肌瘤患者110例,观察术后6个月月经量和肌瘤体积变化情况,将疗效分为显效、有效和无效,分析可能影响疗效的因素。结果 HIFU治疗子宫肌瘤成功率为100%、平均消融率为(73.02±10.87)%、术后第6个月肿瘤减少率为(38.53±37.30)%。显效34例(30.9%)、有效者49例(44.5%)、无效者27例(24.5%)。临床有效率为75.5%。多因素分析结果表明,消融率越高、直径越大的子宫肌瘤疗效越好(P均<0.01);前壁或宫底肌瘤较后壁肌瘤疗效好(P均<0.05);肌壁间肌瘤比黏膜下肌瘤疗效好(P=0.046);T1增强扫描中等强化的子宫肌瘤较明显强化的子宫肌瘤疗效好(P=0.015),差异均有统计学意义。结论消融率高、直径大、T1增强扫描中等强化的前壁或肌壁间子宫肌瘤HIFU消融后6个月治疗效果好。
Objective To investigate the clinical effect of high-intensity focused ultrasound(HIFU) ablation in treatinguterine fibroids, and to discuss the factors influencing curative effect. Methods A total of110 patients with uterine fibroids, who were treated with HIFU during the period from May 2016 to January2019 at authors’ hospital, were enrolled in this study. The changes in the amount of menstrual blood and in thevolume of uterine fibroids at 6 months after HIFU were calculated. Based on the curative effect the patients were divided into three groups: remarkably effective group, effective group and ineffective group, and the factors that may affect curative effect were analyzed. Results The technical success rate of HIFU was 100%, and the average ablation rate of lesionswas(73.02±10.87)%. Six months after HIFU the meanvolume of uterinefibroids was reduced by(38.53±37.30)%. Remarkably effective response was obtained in 34 patients(30.9%), effective response in 49 patients(44.5%) and ineffective response in 27 patients(24.5%). The overall clinical effective rate was 75.5%. Multivariate analysis indicated that the higher the ablation rate was as well as the larger the diameter of uterinefibroid was, the better the curative effect would be(P<0.01 in all). The curative effect of the uterinefibroids located at the anterior wall or the fundus of uteruswas better than that of the uterinefibroids located atthe posterior wall of uterus(P<0.05 in all). The curative effect of intermuscular fibroids was better than that of submucosal fibroids(P =0.046). The curative effect of uterinefibroids that displayed moderate enhancement on T1 WIwas better than that of uterinefibroids that displayed remarkable enhancement on T1 WI(P=0.015), and the difference between the two was statistically significant. Conclusion The anterior wall or intermuscular uterinefibroids which are large in diameter, obtain high ablation rate and show moderate enhancement on T1 WIcan have much better curative effect at six months after HIFU ablation.
作者
潘文秋
汤蕊嘉
赵卫
胡继红
姜永能
王滔
PAN Wenqiu;TANG Ruijia;ZHAO Wei;HU Jihong;JIANG Yongneng;WANG Tao(Department of Medical Imaging,First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province 650032,China)
出处
《介入放射学杂志》
CSCD
北大核心
2019年第11期1086-1090,共5页
Journal of Interventional Radiology
关键词
子宫肌瘤
高强度聚焦超声
疗效
影响因素
uterine fibroid
high-intensity focused ultrasound
curative effect
influencing factor
