Abstract

Objective

To explore correlations between the therapeutic effect of high intensity focused ultrasound (HIFU) and histopathological characteristics of uterine fibroids with different Shear Wave Velocity (SWV) values.

Methods

A retrospective study was conducted on 36 women (43 fibroids) who had undergone high intensity focused ultrasound (HIFU) uterine fibroids ablation between January 2019 and January 2020. Preoperative fibroids tissue sections were obtained for histopathological examination. The pathological sections were stained with Masson-trichrome, and were observed and imaged under a Low-power microscope (4 × 10), while the smooth muscle cell (SMC) and collagen fiber content were semi-quantitatively measured. Preoperative fibroid SWV was measured using the Virtual Touch tissue quantification (VTQ) technique. Within one month after HIFU ablation, all patients had undergone a pelvic cavity MRI examination, which measured the size, volume, and non-perfused volume (NPV) of the fibroids. The formula: the ablation rate = NPV/target fibroid volume × 100% was used to calculate the ablation rate of the uterine fibroids. Correlation analysis of SWV values, HIFU ablation rate, along with the smooth muscle cell (SMC) and collagen fiber content, were conducted using the Spearman’s correlation test.

Results

The collagen fiber and SMC content of the preoperative fibroids were 32.09 ± 15.90%/view and 37.61 ± 15.32%/view, respectively. Preoperative fibroid SWV value was 3.56 ± 0.71 m/s. Preoperative fibroid SWV was negatively correlated with SMC content (r = −0.445, p = 0.003), but positively correlated with collagen fiber content (r = 0.454, p = 0.002). The ablation rate was negatively correlated with collagen fiber content (r = −0.377, p = 0.013), but positively correlated with SMC content (r = 0.402, p = 0.007).

Conclusion

Differences in histopathological characteristics may be important factors that induce differences in the therapeutic effects of HIFU ablation on uterine fibroids with different SWV values.

中文翻译：

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高强度聚焦超声（HIFU）消融术对不同横波速度（SWV）的子宫肌瘤的治疗效果差异：组织病理学特征的研究

摘要

目的

探讨高强度聚焦超声（HIFU）的治疗效果与不同横波速度（SWV）值的子宫肌瘤组织病理学特征之间的相关性。

方法

回顾性研究对36例女性（43例肌瘤）进行了回顾性研究，这些妇女在2019年1月至2020年1月间接受了高强度聚焦超声（HIFU）子宫肌瘤消融术。病理切片用Masson三色染色，并在低倍显微镜（4×10）下观察和成像，同时半定量测量平滑肌细胞（SMC）和胶原纤维含量。术前肌瘤SWV使用虚拟触摸组织定量（VTQ）技术进行测量。HIFU消融后一个月内，所有患者均接受了骨盆腔MRI检查，该检查测量了肌瘤的大小，体积和非灌注体积（NPV）。公式：消融率= NPV /目标肌瘤体积×100％，用于计算子宫肌瘤的消融率。使用Spearman相关检验对SWV值，HIFU消融率以及平滑肌细胞（SMC）和胶原纤维含量进行相关分析。

结果

术前肌瘤的胶原纤维和SMC含量分别为32.09±15.90％/视野和37.61±15.32％/视野。术前肌瘤SWV值为3.56±0.71m  / s。术前肌瘤SWV与SMC含量呈负相关（r = -0.445，p = 0.003），但与胶原纤维含量呈正相关（r = 0.454，​​p = 0.002）。消融率与胶原纤维含量呈负相关（r = -0.377，p = 0.013），而与SMC含量呈正相关（r = 0.402，p = 0.007）。

结论

组织病理学特征的差异可能是导致HIFU消融对SWV值不同的子宫肌瘤治疗效果差异的重要因素。