| HIFU消融子宫肌瘤后浆肌层损伤对消融治疗有效性及安全性的影响 |
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| 引用本文： | 魏庆,陈锦云,刘一诺,莫绍江,张蓉,陈文直.HIFU消融子宫肌瘤后浆肌层损伤对消融治疗有效性及安全性的影响[J].中国介入影像与治疗学,2019,16(8):455-459. |
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| 作者姓名： | 魏庆 陈锦云 刘一诺 莫绍江 张蓉 陈文直 |
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| 作者单位： | 重庆医科大学生物医学工程学院省部共建国家重点实验室培育基地—重庆市超声医学工程重点实验室重庆市生物医学工程学重点实验室重庆微无创医学协同创新中心;重庆医科大学附属第一医院超声消融治疗中心 |
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| 基金项目： | 国家重点基础研究发展计划（973计划）项目（2012CB722402）、国家"十二五"科技支撑计划课题项目（2011BAI14B01）。 |
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| 摘 要： | 目的探讨HIFU消融子宫肌瘤后浆肌层损伤对消融治疗有效性及安全性的影响。方法对400例接受HIFU消融治疗的子宫肌瘤患者,依据术后增强MR T1WI显示子宫肌层灌注全时段矢状位或轴位图像上子宫浆肌层是否出现灌注缺损分为损伤组和完整组。比较2组间患者年龄、体质量指数(BMI)、子宫肌瘤位置、类型(浆膜下、黏膜下及肌壁间肌瘤)、体积、肌瘤前缘至前腹壁的距离、消融参数(功率、总剂量)、消融后肌瘤无灌注区体积(NPV)、消融率、能效因子、术后并发症及患者术后妊娠率的差异。结果损伤组90例,完整组310例。2组间患者年龄、子宫肌瘤体积、肌瘤前缘至前腹壁的距离、HIFU消融功率、NPV差异均无统计学意义(P均0.05),宫肌瘤位置及类型差异均有统计学意义(P均0.05);损伤组较完整组患者BMI及消融率更高(P均0.05)、HIFU消融总剂量及EEF更低(P均0.05)。2组均未出现国际介入放射治疗学会(SIR)分级C～F级并发症,发热、骶尾部疼痛、下腹部疼痛等SIR A、B级并发症差异均无统计学意义(P均0.05);术后妊娠率分别为5.56%(5/90)及2.26%(7/310),差异无统计学意义(χ~2=1.596,P=0.206),无妊娠及分娩相关不良事件发生。结论 HIFU消融子宫肌瘤后可能出现子宫浆肌层损伤,高BMI、位于宫底的浆膜下肌瘤、易消融肌瘤(消融剂量及EEF低、消融率高)HIFU消融术后浆肌层损伤风险高。浆肌层损伤对于术后妊娠及分娩并无显著影响。
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| 关 键 词： | 子宫肿瘤 高强度聚焦超声消融术 肌瘤 浆肌层损伤 磁共振成像 |
| 收稿时间： | 2018/10/29 0:00:00 |
| 修稿时间： | 2019/5/19 0:00:00 |
Impact on treatment safety and efficacy of seromuscular-layer injury after HIFU ablation for uterine fibroids |
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| WEI Qing,CHEN Jinyun,LIU Yinuo,MO Shaojiang,ZHANG Rong and CHEN Wenzhi.Impact on treatment safety and efficacy of seromuscular-layer injury after HIFU ablation for uterine fibroids[J].Chinese Journal of Interventional Imaging and Therapy,2019,16(8):455-459. |
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| Authors: | WEI Qing CHEN Jinyun LIU Yinuo MO Shaojiang ZHANG Rong and CHEN Wenzhi |
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| Institution: | College of Biomedical Engineering, Chongqing Medical University, State Key Laboratory ofUltrasound Engineering in Medicine Co-founded by Chongqing and the Ministry ofScience and Technology, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Collaborative Innovation Center for Minimally-invasive andNoninvasive Medicine, Chongqing 400016, China,College of Biomedical Engineering, Chongqing Medical University, State Key Laboratory ofUltrasound Engineering in Medicine Co-founded by Chongqing and the Ministry ofScience and Technology, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Collaborative Innovation Center for Minimally-invasive andNoninvasive Medicine, Chongqing 400016, China;Ultrasound Ablation Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China,College of Biomedical Engineering, Chongqing Medical University, State Key Laboratory ofUltrasound Engineering in Medicine Co-founded by Chongqing and the Ministry ofScience and Technology, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Collaborative Innovation Center for Minimally-invasive andNoninvasive Medicine, Chongqing 400016, China,College of Biomedical Engineering, Chongqing Medical University, State Key Laboratory ofUltrasound Engineering in Medicine Co-founded by Chongqing and the Ministry ofScience and Technology, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Collaborative Innovation Center for Minimally-invasive andNoninvasive Medicine, Chongqing 400016, China,College of Biomedical Engineering, Chongqing Medical University, State Key Laboratory ofUltrasound Engineering in Medicine Co-founded by Chongqing and the Ministry ofScience and Technology, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Collaborative Innovation Center for Minimally-invasive andNoninvasive Medicine, Chongqing 400016, China;Ultrasound Ablation Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China and College of Biomedical Engineering, Chongqing Medical University, State Key Laboratory ofUltrasound Engineering in Medicine Co-founded by Chongqing and the Ministry ofScience and Technology, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Collaborative Innovation Center for Minimally-invasive andNoninvasive Medicine, Chongqing 400016, China |
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| Abstract: | |
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| Keywords: | uterine neoplasms high-intensity focused ultrasound ablation myoma seromuscular-layer injury magnetic resonance imaging |
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