高强度聚焦超声消融子宫肌瘤疗效相关因素分析

Analysis of related factors of the effect of high intensity focused ultrasound abaltion for uterine fibroids

目的通过多因素及单因素相关性分析,探讨影响高强度聚焦超声消融治疗子宫肌瘤疗效的因素。方法 73例(共97个肌瘤)确诊为子宫肌瘤的患者,进行超声消融治疗。根据肌瘤大小、类型、位置、患者年龄、MRI-T2信号、MRI-T1增强信号、治疗平均功率进行分组。术后1个月通过增强MRI进行疗效评估,分为显效(消融率>50%)、有效(消融率<50%)两个等级。分析肌瘤不同大小、类型、位置、患者年龄、T2信号、T1增强信号、平均功率与疗效的关系。结果前壁的疗效优于其他位置的治疗效果(P<0.05);T1增强信号越高疗效越差(P<0.05);T2高信号的疗效低于T2低信号和等信号,但差异无统计学意义(P>0.05);而肌瘤的大小、类型、患者的年龄与疗效无相关性。结论通过对子宫肌瘤不同因素与疗效关系分析,可以为进一步预测疗效、指导临床应用提供依据。

Objective To investigate the influencing factors of therapeutic efficacy of high intensity focused ultrasound （HIFU）treatment for uterine fibroids through multi-factor and single factor correlation analysis. Methods A total of 73 patients with uterine fibroids （97 uterine fibroids in total） were treated with HIFU. The uterine fibroids were divided into 7 groups according to each factor： diameter, types, site, patients age, MRI-T2 signal, MRI-T1 enhanced signal, average power. At 1 months after HIFU treatment, the results were assessed by MRI examination. The treatment outcomes were of two classes：excellent （ablation rate 〉 50% ）, effective （0 〈 ablation rate 〈 50% ）. Analyzing the correlation between therapeutic efficacy and each influencing factors. Results The therapeutic efficacy related to the site of fibroids and T1 enhanced signal. The therapeutic efficacy of anterior fibroid is better than other locations fibroids. The higher of enhanced T1 signal the worse the effect. Conclusions Analysis of the correlation between the influencing factors of uterine fibroids and the efficacy of HIFU is helpful for evaluating the accuracy of the effect of HIFU ; and can guide change strategies to improve the efficacy of clinical treatment.