| 李俊书,王勇,王李纲,王亮,潘长清,齐成秋.HIFU治疗子宫平滑肌瘤后腹壁水肿程度的影响因素[J].中国介入影像与治疗学,2025,22(3):173-177 |
| HIFU治疗子宫平滑肌瘤后腹壁水肿程度的影响因素 |
| Impact factors of abdominal wall edema degree after HIFU for uterine leiomyoma |
| 投稿时间：2024-12-16 修订日期：2025-02-21 |
| DOI：10.13929/j.issn.1672-8475.2025.03.005 |
| 中文关键词: 子宫肿瘤 平滑肌瘤 高强度聚焦超声消融 磁共振成像 |
| 英文关键词:uterine neoplasms leiomyoma high-intensity focused ultrasound ablation magnetic resonance imaging |
| 基金项目:超声医学工程国家重点实验室开放课题项目（2022KFKT010）。 |
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| 中文摘要: |
| 目的 观察高强度聚焦超声（HIFU）治疗子宫平滑肌瘤（UL）后腹壁水肿程度的影响因素。方法 回顾性分析128例接受HIFU的单发UL患者，根据T2WI所示水肿累及腹壁层次及皮下硬结程度将其分为Ⅰ、Ⅱ及Ⅲ度，比较患者一般资料、UL MRI特征、HIFU相关参数及不良反应，以无序多分类logistic回归分析筛选相关影响因素。结果 腹壁水肿Ⅰ度79例（79/128，61.72%）、Ⅱ度27例（27/128，21.09%）、Ⅲ度22例（22/128，17.19%）。相比Ⅲ度，Ⅰ、Ⅱ度患者体质量指数（BMI）较小，Ⅰ度患者皮下脂肪层厚度及脂肪层+肌层厚度亦较小（校正P均＜0.05）；Ⅰ度患者中腹壁瘢痕占比低于Ⅱ度（校正P＜0.05）。不同腹壁水肿程度之间HIFU前UL MRI表现及治疗参数差异均无统计学意义（P均＞0.05）。BMI及腹壁瘢痕为区分HIFU后腹壁Ⅰ度与Ⅲ度水肿、BMI为区分Ⅱ度与Ⅲ度水肿的独立因素（P均＜0.05）。结论 BMI及腹壁瘢痕是HIFU治疗UL后腹壁水肿程度的影响因素。 |
| 英文摘要: |
| Objective To observe the impact factors of abdominal wall edema degree after high intensity focused ultrasound （HIFU） ablation for uterine leiomyoma （UL）. Methods Totally 128 patients with solitary UL who underwent HIFU were retrospectively enrolled. Edema degree of abdominal wall showed on T2WI were classified into grade Ⅰ， Ⅱ and Ⅲ according to the involved layers and subcutaneous indurations. Patients’ general data， MRI characteristics of UL， HIFU parameters and adverse reactions were compared among grades. Multinomial logistic regression analysis was used to screen the impact factors of edema degree. Results Among 128 patients， grade Ⅰ edema was found in 79 cases （79/128， 61.72%）， while grade Ⅱ and Ⅲ were observed in 27 （27/128， 21.09%） and 22 （22/128， 17.19%） cases， respectively. Compared with patients with grade Ⅲ edema， those with grades Ⅰ and Ⅱ had lower body mass index （BMI）， and patients with grade Ⅰ edema had decreased subcutaneous fat thickness and decreased total thickness of subcutaneous fat and muscle layers （both adjusted P＜0.05）. The proportion of abdominal scars in patients with grade Ⅰ edema was lower than that with grade Ⅱ （adjusted P＜0.05）. No significant difference of MRI findings of UL before HIFU nor HIFU parameters was noticed among different grades of edema （all P＞0.05）. BMI and abdominal scar were both impact factors for distinguishing grade Ⅰ and Ⅲ ， while BMI was the impact factor for distinguishing grade Ⅱ and Ⅲ edema after HIFU for UL （all P＜0.05）. Conclusion BMI and abdominal scar were both impact factors for abdominal wall edema degree after HIFU for UL. |
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