자궁근종에 대한 용적가열방식의 하이푸소작술: 치료 속도 분석 및 속도에 영향을 미치는 인자에 대한 연구
- 주저자 : Park MJ, Kim YS(주저자 : 김영선), Keserci B, Rhim H, Lim HK - 영문 제목 : Volumetric MR-guided high-intensity focused ultrasound ablation of uterine fibroid: treatment speed and factors influencing speed - 한글 제목 : 자궁근종에 대한 용적가열방식의 하이푸소작술: 치료 속도 분석 및 속도에 영향을 미치는 인자에 대한 연구 - 저널 : Eur Radiol - 연도 : 2013 - 권 / 쪽 : 23 / 943-950 - 초록
OBJECTIVES: To assess the treatment speed of volumetric magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablation of symptomatic uterine fibroids, with a focus on factors affecting treatment speed.
METHODS: We received Institutional Review Board approval, and informed consent was obtained from all participants. Among 109 patients referred, 43 women (39.4 %) (mean age, 43.7 years), with 112 fibroids passed the screening. We treated 53 symptomatic uterine fibroids (47.3 %, 53/112) (volume, 341.2 ± 256.5 ml) using volumetric MR-HIFU ablation. We assessed procedure times, non-perfused volume (NPV) and treatment speed (NPV/treatment time). We statistically analysed the factors affecting treatment speed using multiple logistic regression tests.
RESULTS: Technical success was achieved in 42 of 43 cases. MR room time (from entrance to exit) and treatment time (from first to last sonication) were 216.0 ± 40.6 min and 131.5 ± 55.9 min, respectively. Immediate NPV was 178.9 ± 147.3 ml, which was 57.4 ± 25.5 % of the fibroid volume. Treatment speed was 81.8 ± 48.0 ml/h. Multivariate analysis showed that a large fibroid volume (P < 0.001), a low signal intensity ratio of fibroid to skeletal muscle on T2-weighted images (P = 0.009) and timing after completion of the learning curve (P < 0.001) significantly increased treatment speed.
CONCLUSION: Volumetric MR-HIFU ablation can effectively treat symptomatic uterine fibroids. The treatment speed appeared to improve when treating large and/or dark fibroids as well as upon completion of the learning curve.