Identification of an optimal magnetic resonance imaging-based
classification for evaluating efficacy of ultrasound-guided
high-intensity focused ultrasound
Abstract
Objective: To identify an optimal magnetic resonance imaging-based
classification for evaluating the efficacy of focused ultrasound
ablation surgery (FUAS). Design:A retrospective cohort study. Setting:
The Affiliated Nanchong Central Hospital of North Sichuan Medical
College, Nanchong, Sichuan, China. Population: A total of 643
adenomyosis patients who received FUAS from June 2017 to December 2021.
Methods: One-way ANOVA test and chi square test were used to identify an
optimal classification for evaluating FUAS efficacy. Magnitude of the
optimal classification relating to timing of recurrence in FUAS group
was measured by cox regression with hazard ratio (HR) and 95% CI. K-M
curve was applied to estimate the medium recurrence time of adenomyosis
in the optimal classification. Main outcome measures: The identification
of different classifications for FUAS efficacy and the factors
contributing to recurrence after FUAS. Results: The rates of
dysmenorrhea relief (χ2=10.079, P=0.018) and recurrence could be
identified by classification 2 in FUAS group (χ2=10.582, P=0.014), but
not in FUAS+ group (P>0.05). Besides, the recurrence rate in FUAS group
(22.2.0%) was higher than that in FUAS+ group (12.1%). Extrinsic
subtype in classification 2 (HR=2.315, 95% CI 1.219~4.560, P=0.011)
correlated to recurrence of adenomyosis in FUAS group. K-M curve showed
that the medium recurrence time of extrinsic subtype (45.2 months) was
shorter than that of other subtypes (52.0 months). Conclusions:
Classification 2 was the optimal one to identify the rates of
dysmenorrhea relief and recurrence. Extrinsic subtype was related to the
earlier onset of recurrence after FUAS.