Factors associated with thermal injury of abdominal skin in focused ultrasound ablation of uterine fibroids

作者全名："Chendian, Tang; Guohua, Huang; Wang, Zhibiao; Fang, Liu; Luo, Shuang; Liu, Xiaofang; Shi, Qiuling"

作者地址："[Chendian, Tang; Wang, Zhibiao; Shi, Qiuling] Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing, Peoples R China; [Chendian, Tang; Wang, Zhibiao] Chongqing Med Univ, Chongqing Key Lab Biomed Engn, Chongqing, Peoples R China; [Chendian, Tang; Guohua, Huang; Fang, Liu; Luo, Shuang; Liu, Xiaofang] Suining Cent Hosp, Dept Obstet & Gynecol, Suining, Peoples R China; [Shi, Qiuling] Chongqing Med Univ, Sch Publ Hlth, Chongqing, Peoples R China; [Liu, Xiaofang] Suining Cent Hosp, Dept Obstet & Gynecol, Suining 629000, Peoples R China"

通信作者："Shi, QL (通讯作者)，Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing, Peoples R China.; Shi, QL (通讯作者)，Chongqing Med Univ, Sch Publ Hlth, Chongqing, Peoples R China.; Liu, XF (通讯作者)，Suining Cent Hosp, Dept Obstet & Gynecol, Suining 629000, Peoples R China."

来源：INTERNATIONAL JOURNAL OF HYPERTHERMIA

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001134519100001

JCR分区：Q2

影响因子：3

年份：2024

卷号：41

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Focused ultrasound ablation surgery; uterine fibroid; adverse effect; thermal injury; skin

摘要："ObjectiveTo investigate the factors which may cause thermal injury of abdominal skin in patients with uterine fibroids (UFs) who underwent ultrasound-guided focused ultrasound ablation surgery (FUAS).MethodA total of 123 patients were enrolled in the injury group. In contrast, 246 patients without thermal injury were assigned to the non-injury group. The relationship between patient and treatment parameters and injury were explored using univariate analysis and multiple logistic regression analyses. In addition, the factors influencing the degree of thermal injury were analyzed using Kruskal-Wallis H.Results(1) Abdominal scars (p = .007, OR = 2.187, 95% CI: 1.242-3.849), abdominal wall thickness (p < .001, OR = 1.042, 95% CI: 1.019-1.067), fundus fibroids (p = .038, OR = 1.790, 95% CI: 1.033-3.100), UFs with hyperintense/mixed T2-weighted imaging (T2WI) signals (p = .022, OR = 1.843, 95% CI: 1.091-3.115), average sonication power (AP) (p = .025, OR = 1.021, 95% CI: 1.003-1.039), and treatment time (TT) (p < .001, OR = 1.017, 95% CI: 1.011-1.023) were independent risk factors for thermal injury, while treatment volume (TV) (p = .002, OR = 0.775, 95% CI: 0.661-0.909) was a protective factor for injury. (2) Four groups were subdivided according to the degree of thermal injury(Group A: without skin injury. Group B: with changed T2WI signal in the abdominal wall, Group C: mild skin injury, Group D: severe skin injury), comparison of each with every other showed that the abdominal wall in Groups A and D was thinner than Groups B and C, with statistically significant differences (PAB<0.05, PAC<0.01, PDC<0.05, PDB<0.05); Group A was slightly thicker than D, however, without statistical difference. The ratio of sonication time (ST) to TV in Group A was the lowest of all (PAB, PAC, PAD all < 0.05). And as the level of thermal injury rose, the ratio gradually increased, however, without statistical difference.ConclusionsBased on our limited results, the following conclusion was made. (1) Abdominal scars, abdominal wall thickness, fundus fibroids, UFs with T2WI hyperintense/mixed signals, AP and TT were independent risk factor. (2) Neither too thick nor too thin abdominal walls would be recommended, as both might increase the risk of skin injury. (3) Noticeably, the risk of skin injury might increase considerably when the ST was longer and the sonication area was more fixed."

基金机构：Foundation of State Key Laboratory of Ultrasound in Medicine and Engineering

基金资助正文：The authors gratefully acknowledge the support of the continuing education and training center for non-invasive and micro-invasive medicine of Chongqing Medical University/Suining Central Hospital.