Abstract

Background

High-intensity focused ultrasound (HIFU) is a promising and non-invasive therapy for symptomatic uterine fibroids. Currently, the main image-guided methods for HIFU include magnetic resonance-guided (MR-HIFU) and ultrasound-guided (US-HIFU). However, there are few comparative studies on the therapeutic efficacy and safety of MR-HIFU and US-HIFU in treating symptomatic uterine fibroids with a volume <300 cm³.

Objective

We performed this meta-analysis to evaluate the efficacy and safety of MR-HIFU and US-HIFU in treating symptomatic uterine fibroids with a volume <300 cm³.

Methods

We searched relevant literature in PubMed, EMBASE, Cochrane Library CNKI from inception until 2021. The mean value, the proportion, and their 95% confidence intervals (CIs) were measured by random-effects models. Publication bias was assessed using funnel plots.

Results

48 studies met our inclusion criteria—28 describing MR-HIFU and 20 describing US-HIFU. The mean non-perfused volume rate (NPVR) was 81.07% in the US-HIFU group and 58.92% in the MR-HIFU group, respectively. The mean volume reduction rates at month-3, month-6, and month-12 were 42.42, 58.72, and 65.55% in the US-HIFU group, while 34.79, 37.39, and 36.44% in the MR-HIFU group. The incidence of post-operative abdominal pain and abnormal vaginal discharge in the US-HIFU group was lower than that of MRI-HIFU. However, post-operative skin burn and sciatic nerve pain were more common in the US-HIFU group compared with MRI-HIFU. The one-year reintervention rate after MR-HIFU was 13.4%, which was higher than 5.2% in the US-HIFU group.

Conclusion

US-HIFU may show better efficiency and safety than MR-HIFU in treating symptomatic fibroids with a volume <300 cm³.

中文翻译：

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MR-HIFU和US-HIFU治疗体积<300 cm3子宫肌瘤的疗效和安全性：荟萃分析

摘要

背景

高强度聚焦超声 (HIFU) 是一种有前途的非侵入性治疗有症状的子宫肌瘤。目前，HIFU的主要图像引导方法包括磁共振引导（MR-HIFU）和超声引导（US-HIFU）。然而，关于MR-HIFU和US-HIFU治疗体积<300 cm ^{3 的}症状性子宫肌瘤的疗效和安全性的比较研究很少。

客观的

我们进行了这项荟萃分析，以评估 MR-HIFU 和 US-HIFU 在治疗体积 <300 cm ^{3 的}有症状的子宫肌瘤中的有效性和安全性。

方法

我们在 PubMed、EMBASE、Cochrane Library CNKI 中检索了自成立至 2021 年的相关文献。均值、比例及其 95% 置信区间 (CI) 由随机效应模型测量。使用漏斗图评估发表偏倚。

结果

48 项研究符合我们的纳入标准——28 项描述了 MR-HIFU，20 项描述了 US-HIFU。US-HIFU 组的平均非灌注容积率 (NPVR) 分别为 81.07% 和 MR-HIFU 组的 58.92%。US-HIFU 组第 3、6 和 12 个月的平均体积减少率分别为 42.42、58.72 和 65.55%，而 MR-HIFU 组为 34.79、37.39 和 36.44%。US-HIFU组术后腹痛、白带异常发生率低于MRI-HIFU组。然而，与 MRI-HIFU 相比，US-HIFU 组的术后皮肤灼伤和坐骨神经疼痛更常见。MR-HIFU 术后一年再干预率为 13.4%，高于 US-HIFU 组的 5.2%。

结论

在治疗体积 <300 cm ^{3 的}有症状的肌瘤时，US-HIFU 可能比 MR-HIFU 显示出更好的效率和安全性。