Comparison of Reintervention Rates for Type 1 and Type 2 Uterine Fibroids Treated With HIFU Ablation With Varying Non-Perfused Volume Ratios to That With TCRM.

IF 2.4 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine Pub Date : 2025-08-05 DOI:10.1002/jum.70011

Tao Tan, Shuang Li, Zhiyun Yang, Jinfeng Lin, Meijie Yang, Liang Hu, Jinyun Chen

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引用次数: 0

Abstract

Objectives: The objective of this study is to investigate the correlation between long-term reintervention rates following high-intensity focused ultrasound (HIFU) ablation with varying non-perfused volume ratios (NPVR) and hysteroscopic transcervical resection of myoma (TCRM) for type 1 and 2 fibroids. Additionally, the study aims to define the technical success criteria in this context.

Methods: This retrospective study included patients with type 1 and 2 fibroids who underwent treatment with HIFU or TCRM between January 2012 and December 2019. Follow-up assessments were conducted to monitor reintervention rates. NPVR, assessed via magnetic resonance imaging (MRI) post-HIFU treatment, served as a technical indicator for comparing reintervention outcomes between HIFU and TCRM. Logistic regression analysis was employed to identify factors influencing reintervention in patients.

Results: A total of 445 patients were enrolled, with successful follow-up on 325 cases, including 181 cases in the HIFU group and 144 cases in the TCRM group, resulting in a follow-up rate of 73%. When NPVR was ≥70% (n = 151), the long-term reintervention rate following HIFU was comparable to that of TCRM. Binary logistic regression analysis revealed age and long-term symptom relief as independent influencing factors influencing reintervention. The cut-off value of age in patients from the HIFU group was determined as 41.5 using receiver operating characteristic curve (ROC) analysis. The reintervention rate was found to be 10.1% (n = 79) for patients aged over 41.5 years, compared to 34.7% (n = 72) for those aged below it.

Conclusion: HIFU emerges as an effective and reliable treatment modality for large type 1 and type 2 uterine fibroids, providing a viable non-invasive alternative for their management. NPVR ≥70% can serve as a technical criterion for successful operation.

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不同非灌注容积比HIFU消融与TCRM治疗1型和2型子宫肌瘤再干预率的比较

目的：本研究的目的是探讨不同非灌注容积比（NPVR）的高强度聚焦超声（HIFU）消融与宫腔镜下经宫颈肌瘤切除术（TCRM）治疗1型和2型肌瘤后长期再干预率的相关性。此外，本研究旨在定义在这种情况下的技术成功标准。方法：本回顾性研究纳入了2012年1月至2019年12月期间接受HIFU或TCRM治疗的1型和2型肌瘤患者。进行随访评估以监测再干预率。通过HIFU治疗后磁共振成像（MRI）评估NPVR，作为比较HIFU和TCRM再干预结果的技术指标。采用Logistic回归分析确定影响患者再干预的因素。结果：共纳入445例患者，成功随访325例，其中HIFU组181例，TCRM组144例，随访率为73%。当NPVR≥70% （n = 151）时，HIFU后的长期再干预率与TCRM相当。二元logistic回归分析显示年龄和长期症状缓解是影响再干预的独立影响因素。采用受试者工作特征曲线（ROC）分析确定HIFU组患者年龄的临界值为41.5。41.5岁以上患者的再干预率为10.1% (n = 79)， 41.5岁以下患者的再干预率为34.7% （n = 72）。结论：HIFU是治疗大型1型和2型子宫肌瘤的一种有效、可靠的治疗方式，为其治疗提供了一种可行的无创方法。NPVR≥70%可作为操作成功的技术标准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ultrasound in Medicine 医学-核医学

CiteScore

5.10

自引率

4.30%

发文量

205

审稿时长

1.5 months

期刊介绍： The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound