高强度聚焦超声治疗子宫肌瘤后腹壁T2WI表现影响因素

目的 观察高强度聚焦超声(HIFU)治疗子宫肌瘤后腹壁T2WI表现的影响因素。方法 回顾性分析541例因子宫肌瘤接受HIFU治疗患者治疗前后盆腔MRI及HIFU治疗相关资料，根据腹壁T2WI信号有无改变将其分为信号改变组及信号正常组，采用单因素及多因素回归分析腹壁T2WI表现的相关影响因素。结果 135例(135/541，24.95%)信号改变，包括70例(70/135，51.85%)腹壁脂肪层、21例(21/135，15.56%)腹壁肌肉层、44例(44/135，32.59%)腹壁脂肪层及肌肉层信号改变，可见腹壁T2WI呈斑片状或条索状高信号、脂肪抑制(FS)-T2WI呈稍高或混杂高信号；406例(406/541，75.05%)T2WI腹壁信号正常。组间年龄、体质量指数、腹壁厚度、腹壁脂肪厚度、生产史、腹壁瘢痕、子宫肌瘤T2WI信号、HIFU平均功率、治疗时间、辐照时间、治疗强度、治疗剂量、治疗体积及术中皮肤灼烧感差异均有统计学意义(P均<0.05)。腹壁瘢痕、腹壁脂肪厚度、子宫肌瘤T2WI信号、HIFU平均功率、辐照时间、治疗强度、治疗体积及术中皮肤灼烧感均为子宫肌瘤HIFU治疗后腹壁T2WI表现的独立影响因素(P均<0.05)。结论 腹壁瘢痕、腹壁脂肪厚度、肌瘤T2WI信号、HIFU平均功率、辐照时间、治疗强度、治疗体积及术中皮肤灼烧感为子宫肌瘤HIFU治疗后腹壁T2WI表现的影响因素。

Impact factors of T2WI appearances of abdominal wall after high intensity focused ultrasound for treating uterus myoma

Objective To explore the impact factors of T2WI appearances of abdominal wall after high intensity focused ultrasound (HIFU) for treating uterus myoma. Methods Data of pelvic MRI and HIFU procedures of 541 patients who underwent HIFU for treating uterus myoma before and after treatment were retrospectively analyzed. According to changes of T2WI signals of abdominal wall, the patients were divided into signal changed group and signal normal group. Univariate analysis and multivariate regression analysis were used to analyze the relative impact factors of T2WI appearances of abdominal wall. Results T2WI signals of abdominal wall changed in 135 (135/541, 24.95%) cases, including 70 (70/135, 51.85%) cases of fat layer, 21 (21/135, 15.56%) of muscle layer, 44 (44/135, 32.59%) of fat and muscle layer signal changes, presenting as patchy or cordlike high signals on T2WI of abdominal wall, and slightly higher or mixed hypersignals on fat suppression (FS)-T2WI. The signals of abdominal wall on. T2WI remained normal in 406 (406/541, 75.05%) cases. Significant differences of age, body mass index, abdominal wall thickness, abdominal wall fat thickness, birth history, abdominal wall scar, T2WI signal of uterus myoma, HIFU average power, treatment duration, irradiation time, treatment intensity, treatment dose, treatment volume and intraoperative skin burning sensation were between groups (all P<0.05). Abdominal scar, abdominal fat thickness, T2WI signals of uterus myoma, HIFU average power, irradiation time, treatment intensity, treatment volume and intraoperative skin burning sensation were all independent factors of T2WI appearances of abdominal wall after HIFU treatment of uterus myoma (all P<0.05). Conclusion Abdominal scar, abdominal fat thickness, T2WI signals of uterus myoma, HIFU average power, irradiation time, treatment intensity, treatment volume and intraoperative skin burning sensation were all impact factors of T2WI appearances of abdominal wall after HIFU treatment of uterus myoma.