Abstract:
Objective To investigate the ultrasound characteristics of uterine fibroids after radio frequency ablation (RFA) and explore the application of ultrasound in assessing the short-term efficacy of RFA for uterine fibroids.
Methods From June 2015 to March 2018, 71 patients who received radiofrequency ablation for uterine fibroids at the Fourth Affiliated Hospital of Harbin Medical University were included. According to the clinical symptoms, reduction rate of tumor diameter, and contrast-enhanced ultrasound results at 3 months after RFA, the patients were divided into an excellent efficacy group and a good efficacy group, which included 46 cases and 25 cases, respectively. A retrospective analysis of data regarding conventional 2D ultrasound, color Doppler flow imaging (CDFI), ultrasonic elastography, and contrast-enhanced ultrasonography among 71 patients who met the inclusion criteria was performed to identify the preoperative ultrasound characteristics associated with the assessment of short-term efficacy of RFA for uterine fibroids.
Results Univariate analysis showed that hyperechoic fibroids, extensive vascular supply, grade Ⅱ-Ⅲ CDFI blood flow classification, ratio of myoma (E1) to normal muscle layer elasticity (E2) >1, high enhancement on ultrasonography, and uneven distribution of ultrasound contrast agents differed significantly between the two groups (χ2=10.87, 4.70, 12.81, 8.23, 10.99, and 3.92, respectively, P<0.05). Logistic multivariate analysis revealed that hyperechoic fibroids (OR=8.93, 95%CI: 1.79~58.89, P=0.012), CDFI blood flow grade Ⅱ-Ⅲ (OR=9.89, 95%CI: 2.39~53.39, P=0.003), E1/E2>1 (OR=11.66, 95%CI: 2.73~70.50, P=0.002), and uneven distribution of ultrasound contrast agents (OR=5.84, 95%CI: 1.45~30.29, P=0.020) were independent risk factors to predict the efficacy of RFA for uterine fibroids.
Conclusion Preoperative ultrasound may be used to predict the short-term curative effect of RFA for uterine fibroids, helping optimize the radiofrequency ablation treatment plan and select reasonable treatment for patients with risk factors that can predict the efficacy of RFA for uterine fibroids.
Key words:
Uterus,
Leiomyoma,
Ablation techniques,
Ultrasonography,
Risk factors
Kuo Miao, Xiaoqiu Dong, Xiaohui Shao, Dejiao Kong. Ultrasound related risk factors for assessing short-term efficacy of radio frequency ablation for uterine fibroids[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2019, 16(04): 275-280.