高强度聚焦超声消融单发性子宫肌瘤能效因子的影响因素

目的分析单发性子宫肌瘤高强度聚焦超声(HIFU)消融过程中能效因子(EEF)的影响因素。方法回顾性分析218例接受HIFU治疗的单发性子宫肌瘤患者。选择可能影响EEF的因素作为自变量,以EEF为因变量,采用Stepwise regression方法建立多重线性回归模型。结果 HIFU治疗平均EEF为(7.62±5.39)J/mm3。6个预测因子被引入多重线性回归模型,包括靶皮距、前倾位(子宫位置)、贯穿型(肌瘤类型)、肌瘤最大径、低信号(T2WI信号强度)及增强T1WI强化程度。其中EEF与靶皮距、增强T1WI强化程度、贯穿型(肌瘤类型)呈正相关,与肌瘤最大径、低信号(T2WI信号强度)、前倾位(子宫位置)呈负相关,且肌瘤最大径对EEF影响最大(标准系数为-0.292)。结论对子宫呈前倾位且肌瘤血供少、含水量低、最大径长、靶皮距小的非贯穿型单发性子宫肌瘤,HIFU消融EEF小,难度低。

Factors affecting energy efficiency in high intensity focused ultrasound ablation for single uterine myoma

Objective To analyze the factors affecting energy efficiency factor (EEF) in high intensity focused ultrasound (HIFU) ablation for single uterine myoma. Methods Data of 218 patients with single uterine myoma treated with HIFU ablation were retrospectively analyzed. Factors which might affect EEF were selected as independent variables, while EEF was taken as dependent variable. Method of Stepwise regression was used to establish a multiple linear regression model to identify factors that influence HIFU ablation. Results The mean EEF of HIFU was (7.62±5.39)J/mm³. Finally, a total of 6 predictors were selected into the multiple linear regression model, including target skin distance, anteverted (uterine location), transmural (type of uterine myoma), myoma maximum diameter, hypointensity (T2WI signal intensity), enhancement on T1WI enhanced scan. EEF was positively correlated with target skin distance, enhancement on T1WI enhanced scan and transmural (type of uterine myoma), while negatively correlated with maximum diameter of uterine myoma, hypointense (T2WI signal intensity) and anteverted (uterine location), respectively. The maximum diameter of uterine myoma had the greatest influence on EEF (standardization coefficient=-0.292). Conclusion For non-transmural single uterine myoma with less blood supply, low water content, long maximum diameter and short target skin distance in patients with anteverted uterus, EEF of HIFU ablation is small, and the difficulty of HIFU ablation is low.