Magnetic Resonance Imaging-Based Classification Systems for Informing Better Outcomes of Adenomyosis After Ultrasound-Guided High-Intensity Focused Ultrasound Ablating Surgery

作者全名:"Tang, Ying; Hu, Wen-hao; Wang, Hang; Wu, Jia; Wen, Ming-bo; Su, Bin; Jiang, Zhi-jun; Jiang, Xiao; Zhu, Li-juan; Ding, Na; Yang, Ming-tao; Yin, Shu; Hu, Hui-quan; Xu, Fan; Li, Jun; Shi, Qiuling"

作者地址:"[Tang, Ying; Hu, Wen-hao; Wen, Ming-bo; Su, Bin; Ding, Na; Yang, Ming-tao; Yin, Shu; Hu, Hui-quan; Xu, Fan; Li, Jun] North Sichuan Med Coll, Nanchong Cent Hosp, Dept Obstet & Gynecol, Nanchong, Sichuan, Peoples R China; [Tang, Ying; Hu, Wen-hao; Wu, Jia; Shi, Qiuling] Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing, Peoples R China; [Wang, Hang] Si Chuan Mian Yang 404 Hosp, Dept Obstet & Gynecol, Mianyang, Sichuan, Peoples R China; [Jiang, Zhi-jun; Zhu, Li-juan] North Sichuan Med Coll, Nanchong Cent Hosp, Dept Radiol, Nanchong, Sichuan, Peoples R China; [Jiang, Xiao] West Normal Univ, Affiliated Hosp, Dept Obstet & Gynecol, Nanchong, Sichuan, Peoples R China"

通信作者:"Hu, HQ (通讯作者),North Sichuan Med Coll, Nanchong Cent Hosp, Dept Obstet & Gynecol, Nanchong, Sichuan, Peoples R China.; Shi, QL (通讯作者),Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing, Peoples R China."

来源:JOURNAL OF MAGNETIC RESONANCE IMAGING

ESI学科分类:CLINICAL MEDICINE

WOS号:WOS:001062183300001

JCR分区:Q1

影响因子:3.3

年份:2023

卷号: 

期号: 

开始页: 

结束页: 

文献类型:Article; Early Access

关键词:classification; recurrence; dysmenorrhea; menorrhagia; adenomyosis; focused ultrasound ablation surgery

摘要:"Background: A referenced MRI-based classification associated with focused ultrasound ablation surgery (FUAS) outcomes is lacking in adenomyosis. Purpose: To identify an MRI-based classification system for informing the FUAS outcomes. Study Type: Retrospective. Population: Patients with FUAS for adenomyosis, were divided into a training set (N = 643; 355 with post-FUAS gonadotropin-releasing hormone/levonorgestrel, 288 without post-FUAS therapy) and an external validation set (N = 135; all without post-FUAS therapy). Field Strength/Sequence: 1.5 T, turbo spin-echo T2-weighted imaging and single-shot echo-planar diffusion-weighted imaging sequences. Assessment: Five MRI-based adenomyosis classifications: classification 1 (C1) (diffuse, focal, and mild), C2 (intrinsic, extrinsic, intramural, and indeterminate), C3 (internal, adenomyomas, and external), C4 (six subtypes on areas [internal or external] and volumes [< 1/3 or >= 2/3]), and C5 (internal [asymmetric or symmetric], external, intramural, full thickness [asymmetric or symmetric]) for FUAS outcomes (symptom relief and recurrence). S tatistical Tests: The optimal classification was significantly associated with the most subtypes of FUAS outcomes. Relating to the timing of recurrence was measured using Cox regression analysis and median recurrence time was estimated by a Kaplan-Meier curve. A P value < 0.05 was considered statistically significant. Results: Dysmenorrhea relief and recurrence were only associated with C2 in training patients undergoing FUAS alone. Compared with other subtypes, the extrinsic subtype of C2 was significantly associated with dysmenorrhea recurrence in the FUAS group. Besides, the median dysmenorrhea recurrence time of extrinsic subtype was significantly shorter than that of other subtypes (42.0 months vs. 50.3 months). In the validation cohort, C2 was confirmed as the optimal system and its extrinsic subtype was confirmed to have a significantly shorter dysmenorrhea recurrence time than other subtypes."

基金机构:"National Key Projects of Ministry of Science and Technology of China [MOST 2018YFE0113700]; Foundation of State Key Laboratory of Ultrasound in Medicine and Engineering [2020KFKT003, 2021KFKT022]; Project of Nanchong Science and Technology Bureau [22SXQT0254, 22SXQT0344, 22SXQT0134, 22SXQT0121, 22YYJCYJ0074]"

基金资助正文:"The authors thank Xue Li, a scholar majoring in medical translation of Chongqing Medical University, for her thorough review and correction of the English of this paper. This work was supported by National Key Projects of Ministry of Science and Technology of China (MOST 2018YFE0113700), Foundation of State Key Laboratory of Ultrasound in Medicine and Engineering (2020KFKT003, 2021KFKT022), and the Project of Nanchong Science and Technology Bureau (22SXQT0254, 22SXQT0344, 22SXQT0134, 22SXQT0121, 22YYJCYJ0074)."