HIFU治疗超声衰减宽度<10mm声通道腹壁瘢痕子宫肌瘤患者的有效性及安全性  

Efficacy and safety of HIFU ablation for uterine fibroids in patients with abdominal surgical scars in acoustic pathway causing acoustic attenuation width <10mm

作　　者：尹娜 王玲 胡亮[1] 杨超[1,2] 肖智博[3] 陈锦云[1,2] 王智彪[1] YIN Na1, WANG Ling1, HU Liang1 , YANG Chao1,2 , XIAO Zhibo3, CHEN Jinyun1,2, WANG Zhibiao1(1. College of Biomedical Engineering, Chongqing Medical University, State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Collaborative Innovation Center for Minimall y-invasive and Noninvasive Medicine, Chongqing 400016, China ; 2. Ultrasound Ablation Center, 3. Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, Chin)

机构地区：[1]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市微无创医学协同创新中心,重庆400016 [2]重庆医科大学附属第一医院超声消融治疗中心,重庆400042 [3]重庆医科大学附属第一医院放射科,重庆400042

出　　处：《中国介入影像与治疗学》2018年第4期221-225,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家重大科研仪器设备研制专项(81127901);国家自然科学基金面上项目(11574039);重庆市教委科学技术研究项目(KJ1702039)

摘　　要：目的探讨超声引导下HIFU治疗声通道腹壁瘢痕造成超声衰减宽度<10mm的子宫肌瘤患者的安全性及有效性。方法共纳入861例子宫肌瘤患者,于HIFU消融治疗前后行盆腔增强MR检查,其中202例腹壁瘢痕造成超声衰减宽度<10mm(瘢痕组),659例无瘢痕(无瘢痕组),比较2组消融治疗效果、术中不良反应及术后并发症情况。结果对所有患者均完成HIFU治疗,瘢痕组和无瘢痕组子宫肌瘤体积消融率分别为(80.31±18.16)%、(79.60±17.57)%(P=0.620)。瘢痕组术中皮肤烫发生率[52.97%(107/202)]较无瘢痕组[41.58%(274/659)]高(P=0.004),瘢痕组和无瘢痕组术后MRI示腹壁水肿发生率分别为19.80%(40/202)、14.87%(98/659;P=0.095)。结论超声衰减宽度<10mm的声通道腹壁瘢痕对HIFU治疗子宫肌瘤的有效性及安全性无明显影响。Objective To evaluate the therapeutic efficacy and safety of HIFU ablation for uterine fibroids in patients with abdominal surgical scars in acoustic pathway causing acoustic attenuation width 〈10 mm. Methods Totally 861 patients with uterine fibroids were referred for HIFU treatment and underwent contrast-enhanced MR scans before and after HIFU ablation. Among all patients, 202 had abdominal surgical scars causing width 〈10 mm acoustic attenuation （abdominal scars group） and 659 had no abdominal surgical scars （without abdominal scars group）. The outcomes, intra-operative adverse reactions and post-operative complications between the two groups were compared. Results HIFU ablation was successfully performed in all patients. The volume ablation rate was （80.31±18.16）% in abdominal scars group and （79.60±17.57）% in without abdominal scars group （P=0.620）. The rate of ‘hot’ skin sensation during HIFU procedure in abdominal scars group （52.97%[107/202]） was higher than that in without abdominal scars group （41.58%[274/659]; P=0.004）. Anterior abdominal wall edema was found in 40 cases （40/202, 19.80%） in abdominal scars group and 98 cases （98/659, 14.87%） in without abdominal scars group on post-operation MRI （P=0.095）. Conclusion Prior abdominal surgical scars in acoustic pathway causing width 〈10 mm acoustic attenuation has not significantly influence on the efficacy and safety of HIFU treatment for uterine fibroid.

关 键 词：平滑肌瘤 子宫 腹壁 瘢痕 高强度聚焦超声消融 

分 类 号：R737.33[医药卫生—肿瘤] R445.1[医药卫生—临床医学]