高强度聚焦超声治疗子宫肌瘤的消融率的多因素分析  

A multivariate analysis of ablation rate of HIFU in the treatment of uterine fibroids

作　　者：范宏杰[1] 寸江平 姚瑞红[1] 易根发[1] 黄建强[1] 赵卫[1] FAN Hongjie;CUN Jiangping;YAO Ruihong;YI Genfa;HUANG Jianqiang;ZHAO Wei(Department of Imaging,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院影像科,云南昆明650032

出　　处：《实用放射学杂志》2018年第9期1427-1429,1474,共4页Journal of Practical Radiology

基　　金：云南省医疗卫生单位内设研究机构科研项目（2016NS037）。

摘　　要：目的 分析、评估高强度聚焦超声（HIFU）治疗子宫肌瘤中消融率的影响因素。方法 回顾性分析本院2011年9月至2016年12月治疗的症状性子宫肌瘤患者的相关资料，提取所有患者的子宫肌瘤MRI信息和HIFU治疗参数。根据子宫肌瘤的MRI特征，将所有患者分组。所有可能的影响因素被设为自变量，消融率被设定为因变量，使用逐步回归法建立多重线性回归模型。结果 335例患者平均年龄（38.3±6.2）岁，平均消融率（74.4±14.8）%。根据多重线性回归模型可知，子宫肌瘤的类型、位置、T2WI信号强度、T1WI强化类型、靶皮距、体积与消融率之间存在线性关系，且消融率能被这些因素解释的部分占比为38%。相比其余各组，前壁、肌壁间、T2WI低信号强度、T1低强化、短靶皮距的子宫肌瘤消融率更高，更容易进行HIFU消融。结论 HIFU治疗的消融率受多种因素的影响，且前壁、肌壁间、T2WI低信号强度、T1低强化、短靶皮距的子宫肌瘤更容易消融。Objective To analyze and evaluate the influencing factors of ablation rate in the high intensity focused ultrasound（HIFU） treatment of uterine fibroids.Methods Retrospective analysis of the relevant data of patients with symptomatic uterine fibroids treated by our hospital from September 2011 to December 2016 was performed, and all patients＇ uterine fihroids MRI information and HIFU treatment parameters were extracted. According to MRI characteristics of uterine fibroids, all patients were grouped. All possible influencing factors were set as independent variables, and ablation rate was set as dependent variable, using a stepwise regression method to establish multiple linear regression models.Results The mean age of 335 patients was （38.3±6.2） years,and the average ablation rate was （ 74.4 ± 14.8 ） %. According to the multiple linear regression model, type, location, T2 WI signal intensity, enhancement type on T1WI, target skin distance and volume of uterine fibroids, all had a linear relationship with the ablation rate, and the proportion of ablation rate that could be explained by these factors was 38%.Compared with the other groups,the ablation rate was higher in the uterine fibroids of anterior wall,intramural, low signal intensity on T2WI, T1 low enhancement, and short target skin distance, and HIFU ablation was more easily performed.Conclusion The ablation rate in the HIFU treatment was affected by various factors, and the uterine fibroids of anterior wall, intramural, T2WI low signal intensity, T1 low enhancement and short target skin distance were easier to ablate.

关 键 词：高强度聚焦超声 子宫肌瘤 消融率 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]