摘要
目的探讨MR引导下聚焦超声术（MRgFUS）治疗症状性子宫肌瘤的安全性及有效性。方法前瞻性收集25例症状性子宫肌瘤患者行MRgFUS治疗。治疗后即刻行盆腔MRI增强扫描，记录无灌注区（NPV）体积并计算无灌注区体积比（NPV％）。记录治疗前，治疗后1周、1个月、3个月、6个月、12个月以及长期随访过程中的症状严重程度评分（SSS）及标准化SSS评分变化（ASSS）。治疗后12个月复查MRI，记录肌瘤体积、肌瘤体积变化（△V）。观察治疗和随访中的不良反应。采用配对样本t检验（正态分布）或Wilcoxon检验（非正态分布）比较治疗先后连续变量均数的差异，采用Pearson法（正态分布）或Spearman法（非正态分布）进行重复测量数据相关性分析。结果25例患者共31个肌瘤进行了MRgFUS治疗。22例完成了12个月的随访；15例接受远期随访，随访时间34～66个月，平均（55±11）个月。术后即刻NPV为4．5～295．0cm^3，中位数为37．0cm^3；NPV％为6％～94％，平均（64±23）％。术后标准化SSS评分呈持续下降趋势，其中术后1、3、6、12个月及远期随访的标准化SSS评分与术前评分的差异有统计学意义（P〈0．05），术后即刻NPV％与术后1周的标准化SSS评分呈正相关（r=0．552，P=0．005），而与其余各随诊时间点的标准化SSS评分无相关性（P〉0．05）。术后12个月复查子宫肌瘤体积减小，与治疗前差异有统计学意义（P〈0．05），且△V与NPV间具有相关性（7-=0．587，P=0．017）。子宫肌瘤体积、△V与标准化SSS、△SSS间均无相关性（P均〉0．05）。经MRgFUS治疗子宫肌瘤无严重不良反应发生。结论MRgFUS治疗子宫肌瘤安全、有效。
Objective To evaluate the safety and clinical efficacy of the treatment for symptomatic uterine fibroids with MR guided focused ultrasound surgery （MRgFUS） in China. Methods Twenty five selected patients with symptomatic uterine fibroids underwent MRgFUS treatment in our perspective clinical study. Immediately after treatment the patients accepted pelvic enhanced MRI scans, and recorded the non-perfused volume （NPV）and calculated the non-perfused volume ratio （NPV%）. We recorded the symptom severity score （SSS） and standard SSS change （△SSS） of the patients before, during and 1 week after treatment together with 1, 3, 6, 12 months and several years follow-up. The patients accepted pelvic enhanced MRI scans in the follow-up of 12 months after treatment, and recorded the volume and the volume change （△V） of fibroids. We observed the adverse reactions during the treatment and the follow-ups. Wilcoxon test or t test and Pearson or Spearman correlation analysis were used to analyze the data. Results Totally 31 fibroids of 25 patients were completed the treatment. Twenty two patients completed the 12 months follow-up and 15 patients completed the long-term follow-up which was during 34 to 66 months,median follow-up duration was （55±11 ） months. The NPV was 4.5 to 295.0 cm^3, median was 37.0 cm^3. The NPV% was 6% to 94%, average was （64±23）%. According to our follow up, the standard SSS continued to decline. Compared with screening standard SSS, all the follow-up standard SSS had significant difference （P〈 0.05）, except for that of the first week. Among all the follow up, only the standard SSS change of 1 week after the treatment had a correlation with NPV% （r=0.552,P=0.005）, and the others had no significant correlation with NPV% （P〉0.05）. The uterine fibroids volume decreased in the 12 months follow-up, which had a significant difference with the volume before treatment （P〈0.05）. And there was also correlation between the fihroids volume change and NPV （r=0
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2017年第2期149-153,共5页
Chinese Journal of Radiology
关键词
子宫肿瘤
平滑肌瘤
高强度聚焦超声消融
治疗结果
Uterine neoplasms
Leiomyoma
High-intensity focusd ultrasound ablation
Treatment outcome
