Abstract：
To investigate the influencing factors of ultrasound-guided HIFU (USgHIFU) ablation for adenomyosis with a non-perfused volume ratio (NPVR)≥50%.
A total of 299 patients with adenomyosis who underwent USgHIFU ablation were enrolled. Quantitative signal intensity (SI) analysis was performed on T2WI and dynamic enhancement type. The energy efficiency factor (EEF) was defined as the ultrasound energy delivered for ablating 1 mm3 of tissue. NPVR ≥ 50% was used as the criterion for technical success. Adverse effects and complications were recorded. Logistic regression analyses of variables were conducted to identify the factors affecting NPVR ≥ 50%.
The median NPVR was 53.5% (34.7%). There were 159 cases in the NPVR ≥ 50% group and 140 cases in the NPVR < 50% group. The EEF in NPVR < 50.0% group was significantly higher than that in NPVR ≥ 50% group (p < 0.05). The incidence of intraoperative adverse effects and postoperative adverse events in the NPVR < 50% group were higher than those in the NPVR ≥ 50% group (p < 0.05 for both). Logistic regression analysis showed that abdominal wall thickness, SI difference on T2WI between adenomyosis and rectus abdominis, and enhancement type on T1WI were protective factors for NPVR ≥ 50% (p < 0.05), while the history of childbirth was an independent risk factor (p < 0.001).
Compared with NPVR < 50%, NPVR ≥ 50% did not increase the intraprocedural and postprocedural adverse reactions. The possibility of NPVR ≥ 50% was higher in patients with thinner abdominal walls, showed slight enhancement of adenomyosis on T1WI, with a history of childbirth, or in whom the SI difference on T2WI between adenomyosis and rectus abdominis was more minor.
A total of 299 patients with adenomyosis who underwent USgHIFU ablation were enrolled. Quantitative signal intensity (SI) analysis was performed on T2WI and dynamic enhancement type. The energy efficiency factor (EEF) was defined as the ultrasound energy delivered for ablating 1 mm3 of tissue. NPVR ≥ 50% was used as the criterion for technical success. Adverse effects and complications were recorded. Logistic regression analyses of variables were conducted to identify the factors affecting NPVR ≥ 50%.
The median NPVR was 53.5% (34.7%). There were 159 cases in the NPVR ≥ 50% group and 140 cases in the NPVR < 50% group. The EEF in NPVR < 50.0% group was significantly higher than that in NPVR ≥ 50% group (p < 0.05). The incidence of intraoperative adverse effects and postoperative adverse events in the NPVR < 50% group were higher than those in the NPVR ≥ 50% group (p < 0.05 for both). Logistic regression analysis showed that abdominal wall thickness, SI difference on T2WI between adenomyosis and rectus abdominis, and enhancement type on T1WI were protective factors for NPVR ≥ 50% (p < 0.05), while the history of childbirth was an independent risk factor (p < 0.001).
Compared with NPVR < 50%, NPVR ≥ 50% did not increase the intraprocedural and postprocedural adverse reactions. The possibility of NPVR ≥ 50% was higher in patients with thinner abdominal walls, showed slight enhancement of adenomyosis on T1WI, with a history of childbirth, or in whom the SI difference on T2WI between adenomyosis and rectus abdominis was more minor.
摘要：
探讨超声引导下HIFU(USgHIFU)消融非灌注容积比(NPVR)≥50%子宫腺肌病的影响因素。
共纳入299例接受USgHIFU消融的子宫腺肌病患者。对T2WI和动态增强类型进行定量信号强度(SI)分析。能量效率因子(EEF)被定义为为了消融Imm3的组织而递送的超声能量。NPVR≥50%被用作技术成功的标准。记录不良反应和并发症。对各变量进行Logistic回归分析，找出影响NPVR≥50%的因素。
NPVR中位数为53.5%（34.7%）。NPVR≥50%组159例,NPVR<50%组140例。NPVR<50.0%组EEF显著高于NPVR≥50%组(p<0.05)。NPVR<50%组术中不良反应和术后不良事件发生率均高于NPVR≥50%组(均p<0.05)。Logistic回归分析显示腹壁厚度,子宫腺肌病和腹直肌T2WI的SI差异，T1WI的增强类型是NPVR≥50%的保护因素(p<0.05)，而分娩史是独立危险因素(p<0.001)。
与NPVR<50%相比，NPVR≥50%未增加术中和术后不良反应。腹壁较薄的患者NPVR≥50%的可能性更高，在T1WI上显示子宫腺肌病的轻微增强，有分娩史，或其中子宫腺肌病和腹直肌之间的T2WISI差异更小。
共纳入299例接受USgHIFU消融的子宫腺肌病患者。对T2WI和动态增强类型进行定量信号强度(SI)分析。能量效率因子(EEF)被定义为为了消融Imm3的组织而递送的超声能量。NPVR≥50%被用作技术成功的标准。记录不良反应和并发症。对各变量进行Logistic回归分析，找出影响NPVR≥50%的因素。
NPVR中位数为53.5%（34.7%）。NPVR≥50%组159例,NPVR<50%组140例。NPVR<50.0%组EEF显著高于NPVR≥50%组(p<0.05)。NPVR<50%组术中不良反应和术后不良事件发生率均高于NPVR≥50%组(均p<0.05)。Logistic回归分析显示腹壁厚度,子宫腺肌病和腹直肌T2WI的SI差异，T1WI的增强类型是NPVR≥50%的保护因素(p<0.05)，而分娩史是独立危险因素(p<0.001)。
与NPVR<50%相比，NPVR≥50%未增加术中和术后不良反应。腹壁较薄的患者NPVR≥50%的可能性更高，在T1WI上显示子宫腺肌病的轻微增强，有分娩史，或其中子宫腺肌病和腹直肌之间的T2WISI差异更小。
