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影响子宫肌瘤HIFU治疗效果的相关因素分析

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目的 探讨影响高强度聚焦超声(HIFU)治疗子宫肌瘤效果的相关因素,以期为临床治疗提供参考.方法 回顾性分析陕西省商洛市中心医院2020年1月—2023年12月收治的102例子宫肌瘤患者的临床资料.比较不同MRI T2WI信号强度子宫肌瘤患者治疗前后肌瘤体积的百分比变化(NPV%)及术中消融治疗参数.比较有、无T2 WI高信号环征(T2-rim sign)子宫肌瘤患者NPV%及术中消融治疗参数.采用条件Logistic回归分析影响HIFU消融治疗即刻获益的因素.结果 不同MRI T2WI信号强度患者NPV%比较:低信号组>等信号组>高信号组;治疗剂量比较:低信号组<等信号组<高信号组,以上差异均具有统计学意义(P<0.05).但3组患者治疗强度比较,差异无统计学意义(P>0.05).有T2-rim sign组患者NPV%低于无T2-rim sign组患者,治疗强度及治疗剂量均高于无T2-rim sign组,差异均具有统计学意义(P<0.05).NPV%<75%组患者辐照时间长于NPV%≥75%组,治疗强度高于NPV%≥75%组,T2WI信号强度以等信号为主,T2-rim sign较NPV%≥75%组多见,以上差异均具有统计学意义(P<0.05).经条件Logistic回归分析,结果显示影响HIFU消融治疗即刻获益的危险因素包括辐照时间、治疗强度、T2WI信号强度及T2-rim sign(P<0.05).结论 T2-rim sign、T2WI信号强度是HIFU消融子宫肌瘤即刻获益的影响因素.因此,通过观察术前MRI特征可为预估子宫肌瘤患者的HIFU消融效果提供一定的信息.
Factors influencing the efficacy of HIFU treatment for uterine fibroids
Objective To investigate the factors influencing the efficacy of high-intensity focused ultrasound (HIFU) treat-ment for uterine fibroids,providing a clinical reference for treatment.Methods A retrospective analysis was conducted on the clinical data of 102 uterine fibroid patients treated at Shangluo Central Hospital from January 2020 to December 2023.The non-perfused volume percentage (NPV%) and intraoperative ablation parameters were compared among patients with different MRI T2-weighted imaging (T2WI) signal intensities.The NPV% and intraoperative ablation parameters were also compared between patients with and without the T2-rim sign.Conditional logistic regression was used to analyze the factors influencing the immediate benefit of HIFU ablation treatment.Results The comparison of NPV% among patients with dif-ferent MRI T2WI signal intensities showed:low signal group>equal signal group>high signal group;the irradiation time and treatment dose were compared as follows:low signal group<equal signal group<high signal group,with all differences being statistically significant (P<0.05).However,no statistically significant difference was found in treatment intensity a-mong the three groups (P>0.05).Patients with the T2-rim sign had lower NPV% than those without,and higher treat-ment intensity,and treatment dose,all with statistically significant differences (P<0.05).The NPV%<75% group had longer irradiation time and higher treatment intensity than the NPV%≥75% group;medium signal intensity on T2WI was predominant,and the T2-rim sign was more common in the NPV% ≥75% group,with all differences being statistically significant (P<0.05).Logistic regression analysis showed that the factors influencing the immediate benefit of HIFU abla-tion treatment included irradiation time,treatment intensity,T2WI signal intensity,and the T2-rim sign (P<0.05).Con-clusion The T2-rim sign and T2WI signal intensity are factors influencing the immediate benefit of HIFU ablation for uter-ine fibroids.Observing preoperative MRI characteristics can provide useful information for predicting the efficacy of HIFU ablation for uterine fibroid patients.

Uterine fibroidsHigh-intensity focused ultrasoundT2WI high signal rim signNon-perfused volume

陈阳、白云、洪玉锋、肖西峰、李丰玲

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陕西省商洛市中心医院妇产科,陕西商洛 726000

陕西中医药大学第二附属医院西咸院区妇产科,陕西咸阳 712000

空军军医大学唐都医院妇产科,西安 710038

子宫肌瘤 高强度聚焦超声 T2WI高信号环征 非灌注区体积

陕西省重点研发计划项目

2019SF-279

2024

保健医学研究与实践
西南大学

保健医学研究与实践

CSTPCD
影响因子:0.512
ISSN:1673-873X
年,卷(期):2024.21(4)
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