MRI或超声引导下高强度聚焦超声消融治疗子宫肌瘤的效果比较  

Comparison of effect of MRI or ultrasound-guided HIFU ablation in the treatment of uterine fibroids

作　　者：刘晶晶 胡晓君 叶小琳 Liu Jingjing;Hu Xiaojun;Ye Xiaolin(Department of Obstetrics and Gynecology,Xi'an People's Hospital,Shaanxi Province&Xi'an No.4 Hospital,Xi'an 710000,China;Department of Gynecology,Shaanxi Provincial Cancer Hospital,Xi'an 710061,China)

机构地区：[1]陕西省西安市人民医院西安市第四医院妇产科,西安710000 [2]陕西省肿瘤医院妇科,西安710061

出　　处：《中国综合临床》2024年第5期351-356,共6页Clinical Medicine of China

基　　金：陕西省卫生计生科研基金项目(2016D051)。

摘　　要：目的探究磁共振或超声引导下高强度聚焦超声(high intensity focused ultrasound,HIFU)消融治疗子宫肌瘤的临床效果。方法回顾性分析西安市人民医院妇产科2020年4月至2023年2月124例行HIFU消融治疗子宫肌瘤患者的临床资料,按照引导方式不同将患者分为MRI组(行磁共振引导HIFU消融治疗,58例)和超声组(行超声引导HIFU消融治疗,66例),比较两组患者的治疗效果(总有效率、肌瘤消融体积、肌瘤消融率)、手术情况(总耗能、总耗时、能效因子、辐照时间)、不良事件发生情况、术前和术后3个月时卵巢功能[促卵泡生成数(follicle stimulating hormone,FSH)、抑制素B、窦状卵泡数(antral follicle count,AFC)]及术后6、12个月时复发情况。符合正态分布的计量资料组间比较采用t检验,计数资料组间比较采用χ^(2)检验。结果MRI组患者的总耗能、总耗时、辐照时间均高于超声组[(571.68±184.31)kJ比(494.82±155.03)kJ,(186.21±36.19)min比(121.63±31.09)min,(26.12±7.93)min比(22.07±7.46)min],差异均有统计学意义(t值分别为2.52、10.69、2.93,P值分别为0.013、<0.001、0.004);术后3个月时两组患者FSH水平较术前均升高[MRI组:(10.27±1.72)U/L比(8.67±1.63)U/L,超声组:(10.13±1.66)U/L比(8.46±1.57)U/L],抑制素B水平及AFC数量较术前均降低[MRI组:(40.46±5.31)ng/L比(47.19±4.24)ng/L,(4.22±1.21)个比(6.72±1.48)个;超声组:(39.07±5.12)ng/L比(48.20±4.77)ng/L,(4.11±1.09)个比(6.63±1.41)个],差异均有统计学意义(t值分别为5.14、5.94、7.54、9.96、10.60、11.48,均P<0.001)。结论两种方式引导下HIFU消融治疗子宫肌瘤,均可有效消融肌瘤,并改善卵巢功能,具有安全性,超声引导较MRI引导治疗时间更短、耗能更少。Objective To explore the clinical effect of magnetic resonance imaging(MRI)or ultrasound-guided high intensity focused ultrasound(HIFU)ablation in the treatment of uterine fibroids.Methods The clinical data of 124 patients with uterine fibroids who received HIFU ablation in the Department of Obstetrics and Gynecology of Xi'an People's Hospital were retrospectively analyzed from April 2020 to February 2023.The patients were divided into an MRI group(58 cases treated with magnetic resonance guided HIFU ablation)and an ultrasound group(66 cases treated with ultrasound guided HIFU ablation)according to different guidance methods.The treatment effects(total effective rate,fibroid ablation volume,fibroid ablation rate),surgical conditions(total energy consumption,total time consumption,energy efficiency factor,irradiation time),incidence of adverse events,ovarian function(follicle stimulating hormone(FSH),inhibin)at 3 months before and after surgery were compared between the two groups.B.Antral follicle count(AFC)and recurrence at 6 and 12 months after surgery.The t-test is used for comparing between groups of metric data that conform to normal distribution,and the chi square test is used for comparing between groups of count data.Results The total energy consumption,total time consumption and irradiation time in MRI group were longer than those in ultrasound group((571.68±184.31)k)vs(494.82±155.03)kj,(186.21±36.19)min vs(121.63±31.09)min,(26.12±7.93)min vs(22.07±7.46)min),there were have statistical differences(t values were 2.52,10.69,and 2.93,respectively;P values were 0.013,<0.001,and 0.004,respectively).At 3 months after surgery,the level of FSH in the two groups was risen than that before surgery(MRI group(10.27±1.72)U/L vs(8.67±1.63)U/L,ultrasound group(10.13±1.66)U/L vs(8.46±1.57)U/L),the level of INHB and the number of AFC were declined(MRI group(40.46±5.31)ng/L vs(47.19±4.24)ng/L,(4.22±1.21)vs(6.72±1.48);ultrasound group(39.07±5.12)ng/L vs(48.20±4.77)ng/L,(4.11±1.09)vs(6.63±1.41)there were h

关 键 词：子宫肌瘤 高强度聚焦超声消融 磁共振 超声检查 卵巢功能 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学] R445.1[医药卫生—临床医学]