目的:本研究的目的是评估经皮冷冻消融治疗腹壁子宫内膜异位症(AWE)结节的疗效。
方法:回顾性纳入了2020年5月至2023年7月间在超声和计算机断层扫描(CT)指导下经皮冷冻消融术治疗有症状的AWE结节的38名女性。使用视觉模拟量表(VAS)估计疼痛,并在基线时进行评估。三个月,六个月,经皮冷冻消融术后12个月。基线VAS评分,将AWE结节的体积和AWE结节的磁共振成像(MRI)特征与经皮冷冻消融术后获得的特征进行比较.主要并发症,如果有的话,被注意到。
结果:38名妇女接受了治疗,中位年龄为35.5岁(四分位距[IQR]:32,39;范围:24-48岁),总共60个AWE结节。30名妇女(30/38;79%)在局部或区域麻醉下进行了经皮冷冻消融。初始中位VAS评分(7;IQR:6,8;范围:3-10)和治疗后3个月的中位VAS评分(0;IQR:0,5;范围;0-8)之间显著降低(P<0.001),观察到6个月(0;IQR:0,1;范围;0-10)(P<0.001)和12个月(0;IQR:0,2;范围:0-7)(P<0.001)。经皮冷冻消融在6个月时可有效缓解38名女性中的31名(82%)疼痛,在12个月时可有效缓解18名女性中的15名(83%)疼痛。随访6个月时对比增强MRI显示,治疗后AWE结节体积明显减少,与基线MRI相比,AWE结节无强化(P<0.001)。无重大并发症报告。
结论:经皮冷冻消融术是一种有效的,用于治疗AWE结节的微创介入治疗,发病率最低或无发病率。
OBJECTIVE: The purpose of this study was to evaluate the efficacy of percutaneous cryoablation in the treatment of abdominal wall endometriosis (AWE) nodules.
METHODS: Thirty-eight women treated for symptomatic AWE nodules with percutaneous cryoablation under ultrasound and computed tomography (CT) guidance between May 2020 and July 2023 were retrospectively included. Pain was estimated using visual analog scale (VAS) and assessed at baseline, three months, six months, and 12 months after percutaneous cryoablation. Baseline VAS score, volume of AWE nodule and magnetic resonance imaging (MRI) features of AWE nodules were compared to those obtained after percutaneous cryoablation. Major complications, if any, were noted.
RESULTS: Thirty-eight women with a median age of 35.5 years (interquartile range [IQR]: 32, 39; range: 24-48 years) and a total of 60 AWE nodules were treated. Percutaneous cryoablation was performed under local or regional anesthesia in 30 women (30/38; 79%). Significant decreases between initial median VAS score (7; IQR: 6, 8; range: 3-10) and median VAS score after treatment at three months (0; IQR: 0, 5; range; 0-8) (P < 0.001), six months (0; IQR: 0, 1; range; 0-10) (P < 0.001) and 12 months (0; IQR: 0, 2; range: 0-7) (P < 0.001) were observed. Percutaneous cryoablation resulted in effective pain relief in 31 out of 38 women (82%) at six months and 15 out of 18 women (83%) at 12 months. Contrast-enhanced MRI at six-month follow-up showed a significant decrease in the volume of AWE nodules and the absence of AWE nodule enhancement after treatment by comparison with baseline MRI (P < 0.001). No major complications were reported.
CONCLUSIONS: Percutaneous cryoablation is an effective, minimally invasive intervention for the treatment of AWE nodules that conveys minimal or no morbidity.