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Abstract：
OBJECTIVE: To report the long-term re-intervention of patients with uterine fibroids after ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation and to analyse the influencing factors of re-intervention in patients in the NPVR ≥ 80% group.
METHODS: Patients with a single uterine fibroid who underwent USgHIFU at our hospital from January 2012 to December 2019 were enrolled. The patients were divided into four groups according to different nonperfusion volume ratio (NPVR). Kaplan-Meier survival curve was used to analyse long-term re-intervention in different NPVR groups, and Cox regression was used to analyse the influencing factors of re-intervention in the NPVR ≥ 80% group.
RESULTS: A total of 1,257 patients were enrolled, of whom 920 were successfully followed up. The median follow-up time was 88 months, and the median NPVR was 85.0%. The cumulative re-intervention rates at 1, 3, 5, 8 and 10 years after USgHIFU were 3.4%, 11.8%, 16.8%, 22.6% and 24.1%, respectively. The 10-year cumulative re-intervention rate was 37.3% in the NPVR < 70% group, 31.0% in the NPVR 70-79% group, 18.2% in the NPVR 80-89% group and 17.8% in the NPVR ≥ 90% group (P < 0.05). However, no difference was found between the group of NPVR 80-89% and the group of NPVR ≥ 90% (P = 0.499). Age of patients and signal intensity on T2-weighted imaging (T2WI) of tumours were found to be independent risk factors for long-term re-intervention in the NPVR ≥ 80% group. A younger age and greater signal intensity on T2W images corresponded to a greater risk of re-intervention.
CONCLUSIONS: USgHIFU, an alternative treatment for uterine fibroids, has reliable long-term efficacy. NPVR ≥ 80% can be used as a sign of technical success, which can reduce re-intervention rates. However, an important step is to communicate with patients in combination with the age of patients and the signal intensity on T2WI of fibroids.
BACKGROUND: This retrospective study was approved by the ethics committee at our institution (Registration No. HF2023001; Date: 06/04/2023). The Chinese Clinical Trial Registry provided full approval for the study protocol (Registration No. CHiCTR2300074797; Date: 16/08/2023).
METHODS: Patients with a single uterine fibroid who underwent USgHIFU at our hospital from January 2012 to December 2019 were enrolled. The patients were divided into four groups according to different nonperfusion volume ratio (NPVR). Kaplan-Meier survival curve was used to analyse long-term re-intervention in different NPVR groups, and Cox regression was used to analyse the influencing factors of re-intervention in the NPVR ≥ 80% group.
RESULTS: A total of 1,257 patients were enrolled, of whom 920 were successfully followed up. The median follow-up time was 88 months, and the median NPVR was 85.0%. The cumulative re-intervention rates at 1, 3, 5, 8 and 10 years after USgHIFU were 3.4%, 11.8%, 16.8%, 22.6% and 24.1%, respectively. The 10-year cumulative re-intervention rate was 37.3% in the NPVR < 70% group, 31.0% in the NPVR 70-79% group, 18.2% in the NPVR 80-89% group and 17.8% in the NPVR ≥ 90% group (P < 0.05). However, no difference was found between the group of NPVR 80-89% and the group of NPVR ≥ 90% (P = 0.499). Age of patients and signal intensity on T2-weighted imaging (T2WI) of tumours were found to be independent risk factors for long-term re-intervention in the NPVR ≥ 80% group. A younger age and greater signal intensity on T2W images corresponded to a greater risk of re-intervention.
CONCLUSIONS: USgHIFU, an alternative treatment for uterine fibroids, has reliable long-term efficacy. NPVR ≥ 80% can be used as a sign of technical success, which can reduce re-intervention rates. However, an important step is to communicate with patients in combination with the age of patients and the signal intensity on T2WI of fibroids.
BACKGROUND: This retrospective study was approved by the ethics committee at our institution (Registration No. HF2023001; Date: 06/04/2023). The Chinese Clinical Trial Registry provided full approval for the study protocol (Registration No. CHiCTR2300074797; Date: 16/08/2023).
摘要：
目的：报告超声引导下高强度聚焦超声(USgHIFU)消融术后子宫肌瘤患者的长期再干预情况，并分析NPVR≥80%组患者再干预的影响因素。
方法：纳入2012年1月至2019年12月在我院接受USgHIFU治疗的单个子宫肌瘤患者。根据不同的非灌注容积比(NPVR)将患者分为4组。Kaplan-Meier生存曲线用于分析不同NPVR组的长期再干预，采用Cox回归分析NPVR≥80%组再次干预的影响因素。
结果：共纳入1,257名患者，其中920人成功跟进。中位随访时间88个月,NPVR中位数为85.0%。USgHIFU后1、3、5、8和10年的累积再干预率为3.4%，11.8%,16.8%,22.6%和24.1%，分别。NPVR<70%组10年累计再干预率为37.3%,在NPVR70-79%组中为31.0%，NPVR80-89%组18.2%,NPVR≥90%组17.8%(P<0.05)。然而,NPVR80-89％组和NPVR≥90％组之间无差异（P=0.499）。发现患者年龄和肿瘤T2加权成像（T2WI）信号强度是NPVR≥80％组中长期再干预的独立危险因素。T2W图像上的较年轻的年龄和较大的信号强度对应于较大的再干预风险。
结论：USgHIFU，子宫肌瘤的替代疗法,具有可靠的长期疗效。NPVR≥80%可以作为技术成功的标志，这可以降低再干预率。然而,一个重要的步骤是结合患者的年龄和肌瘤T2WI的信号强度与患者进行沟通。
背景：这项回顾性研究得到了我们机构伦理委员会的批准（注册号：HF2023001；日期：2023年4月6日）。中国临床试验注册中心为研究方案提供了完全批准（注册编号：CHiCTR2300074797；日期：2023年8月16日）。
方法：纳入2012年1月至2019年12月在我院接受USgHIFU治疗的单个子宫肌瘤患者。根据不同的非灌注容积比(NPVR)将患者分为4组。Kaplan-Meier生存曲线用于分析不同NPVR组的长期再干预，采用Cox回归分析NPVR≥80%组再次干预的影响因素。
结果：共纳入1,257名患者，其中920人成功跟进。中位随访时间88个月,NPVR中位数为85.0%。USgHIFU后1、3、5、8和10年的累积再干预率为3.4%，11.8%,16.8%,22.6%和24.1%，分别。NPVR<70%组10年累计再干预率为37.3%,在NPVR70-79%组中为31.0%，NPVR80-89%组18.2%,NPVR≥90%组17.8%(P<0.05)。然而,NPVR80-89％组和NPVR≥90％组之间无差异（P=0.499）。发现患者年龄和肿瘤T2加权成像（T2WI）信号强度是NPVR≥80％组中长期再干预的独立危险因素。T2W图像上的较年轻的年龄和较大的信号强度对应于较大的再干预风险。
结论：USgHIFU，子宫肌瘤的替代疗法,具有可靠的长期疗效。NPVR≥80%可以作为技术成功的标志，这可以降低再干预率。然而,一个重要的步骤是结合患者的年龄和肌瘤T2WI的信号强度与患者进行沟通。
背景：这项回顾性研究得到了我们机构伦理委员会的批准（注册号：HF2023001；日期：2023年4月6日）。中国临床试验注册中心为研究方案提供了完全批准（注册编号：CHiCTR2300074797；日期：2023年8月16日）。
