Comparison of long-term re-intervention rates following HIFU ablation and myomectomy for uterine fibroids in patients of reproductive age

Tan Tao; Li Shuang; Lin Jinfeng; Yang Zhiyun; Chen Ying; Yang Meijie; Chen Jinyun

doi:10.13406/j.cnki.cyxb.003893

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Comparison of long-term re-intervention rates following HIFU ablation and myomectomy for uterine fibroids in patients of reproductive age

Clinical research | 更新时间：2026-04-15

- Comparison of long-term re-intervention rates following HIFU ablation and myomectomy for uterine fibroids in patients of reproductive age
- Journal of Chongqing Medical University Vol. 51, Issue 4, Pages: 571-575(2026)
- 作者机构：
  
  1.重庆医科大学超声医学工程国家重点实验室生物医学工程学院，重庆 400016
  2.成都市妇女儿童中心医院妇产科，成都 610031
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003893
  CLC： R711.74
- Received：20 March 2025，
  
  Revised：2025-05-11，
  
  Accepted：21 May 2025，
  
  Published：28 April 2026
- 稿件说明：
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谭涛,李霜,林金凤等.育龄期子宫肌瘤患者HIFU消融术与肌瘤剔除术术后远期再干预的比较研究[J].重庆医科大学学报,2026,51(04):571-575.

Tan Tao,Li Shuang,Lin Jinfeng,et al.Comparison of long-term re-intervention rates following HIFU ablation and myomectomy for uterine fibroids in patients of reproductive age[J].Journal of Chongqing Medical University,2026,51(04):571-575.
谭涛,李霜,林金凤等.育龄期子宫肌瘤患者HIFU消融术与肌瘤剔除术术后远期再干预的比较研究[J].重庆医科大学学报,2026,51(04):571-575. DOI： 10.13406/j.cnki.cyxb.003893.

Tan Tao,Li Shuang,Lin Jinfeng,et al.Comparison of long-term re-intervention rates following HIFU ablation and myomectomy for uterine fibroids in patients of reproductive age[J].Journal of Chongqing Medical University,2026,51(04):571-575. DOI： 10.13406/j.cnki.cyxb.003893.

摘要

目的

随访育龄期子宫肌瘤患者高强度聚焦超声（high-intensity focused ultrasound，HIFU）消融术术后疗效，与同期子宫肌瘤剔除术比较，探讨不同年龄段患者HIFU术后再干预率的影响因素。

方法

本研究纳入2012年1月至2019年12月接受HIFU消融术和肌瘤剔除术的子宫肌瘤患者并对其随访，主要包括术后接受子宫肌瘤再次干预的时间、原因、方式等。将2组患者按不同年龄分组，采用Kaplan-Meier 生存曲线及Cox回归分析HIFU后再干预情况及其影响因素，并通过受试者工作特征曲线（receiver operating characteristic，ROC）分析消融率（non-perfused volume ratio，NPVR）与再干预的相关性与最优截断值，并与子宫肌瘤剔除术对比分析。

结果

共纳入3 044例患者，成功随访2 195例（72.1%），HIFU组1 557例，肌瘤剔除术组638例。随访时间分别为88（67，110）个月和95（69，110）个月。子宫肌瘤剔除术术后再干预率为7.8%。HIFU术后再干预率为24.7%。Cox回归分析显示NPVR为HIFU后接受再干预的独立影响因素。40~

45岁组消融率达到76.9%、≥45岁组达到65.5%，2组患者再干预率可与剔除术相当（

0.05）。

35岁组消融率达82.4%，可明显降低远期再干预率，但仍高于子宫肌瘤剔除术。

结论

HIFU消融术治疗育龄期子宫肌瘤患者疗效稳定，40岁以上的患者可获得与子宫肌瘤剔除术相当的远期效果，年轻患者后续需要再次干预的可能性较大。

Abstract

Objective

To compare the efficacy of high-intensity focused ultrasound（HIFU） ablation and myomectomy for uterine fibroids in patients of reproductive age，and to investigate the factors influencing the re-intervention rate after HIFU ablation across different age groups.

Methods

This retrospective study included patients with uterine fibroids who had undergone either HIFU ablation or myomectomy from January 2012 to December 2019. Their follow-up data included the time，reasons，and methods of re-intervention for uterine fibroids. Stratifying patients in each group by age，Kaplan-Meier survival analysis and Cox regression analysis were used to determine post-HIFU re-intervention rate and its influencing factors. Using a receiver operating characteristic curve，the correlation between the non-perfused volume ratio（NPVR） and re-intervention rate was assessed，and the optimal cut-off value was determined. Outcomes with HIFU ablation and myomectomy were compared.

Results

A total of 3044 patients were included，of whom 2195 （72.1%） were successfully followed up，including 1557 in the HIFU group and 638 in the myomectomy group. The median follow-up lengths were 88（67，110） months and 95 （69，110） months for the HIFU and myomectomy groups，respectively. The re-intervention rate was 7.8% after myomectomy and 24.7% after HIFU ablation. The Cox regression analysis revealed that NPVR was an independent predictor of re-intervention after HIFU ablation. In the age groups of 40-

45 years and ≥45 years，the NPVR values were 76.9% and 65.5%，respectively，both with comparable re-intervention rates to those with myomectomy（

0.05）；in the age group of

35 years，the NPVR reached 82.4%，significantly reducing the long-term re-intervention rate，but which was higher than that with myomectomy.

Conclusion

HIFU ablation demonstrates stable efficacy for treating uterine fibroids in patients of reproductive age，achieving comparable long-term outcomes to myomectomy in patients over 40 years old，but with a higher likelihood of subsequent re-intervention in younger patients.

关键词

Keywords

references

子宫肌瘤的诊治中国专家共识专家组 . 子宫肌瘤的诊治中国专家共识 [J ] . 中华妇产科杂志， 2017 ， 52 （ 12 ）： 793 - 800 ．

Chinese expert consensus group on the diagnosis and treatment of uterine fibroids . Consensus for diagnosis and treatment of uterine myoma [J ] . Chin J Obstet Gynecol ， 2017 ， 52 （ 12 ）： 793 - 800 ．

Marsh EE ， Wegienka G ， Williams DR . Uterine fibroids [J ] . JAMA ， 2024 ， 331 （ 17 ）： 1492 ．

Foth D ， Röhl FW ， Friedrich C ， et al . Symptoms of uterine myomas：data of an epidemiological study in Germany [J ] . Arch Gynecol Obstet ， 2017 ， 295 （ 2 ）： 415 - 426 ．

何　敏，易金玲，冉武斌，等 . 高强度聚焦超声治疗南非与中国子宫肌瘤患者的对比研究 [J ] . 重庆医科大学学报， 2018 ， 43 （ 11 ）： 1490 - 1494 ．

He M ， Yi JL ， Ran WB ， et al . High-intensity focused ultrasound in treatment of uterine fibroids in patients in South Africa and China：a comparative analysis [J ] . J Chongqing Med Univ ， 2018 ， 43 （ 11 ）： 1490 - 1494 ．

Chen J ， Li Y ， Wang Z ， et al . Evaluation of high-intensity focused ultrasound ablation for uterine fibroids：an IDEAL prospective exploration study [J ] . BJOG ， 2018 ， 125 （ 3 ）： 354 - 364 ．

Radosa MP ， Owsianowski Z ， Mothes A ， et al . Long-term risk of fibroid recurrence after laparoscopic myomectomy [J ] . Eur J Obstet Gynecol Reprod Biol ， 2014 ， 180 ： 35 - 39 ．

刘欣，汪伟，唐杰，等 . 子宫肌瘤聚焦超声消融手术与子宫肌瘤剔除术的远期临床疗效比较 [J ] . 中华妇产科杂志， 2022 ， 57 （ 4 ）： 244 - 252 ．

Liu X ， Wang W ， Tang J ， et al . Comparison of the long-term outcomes of focused ultrasound ablation surgery for uterine fibroids and myomectomy [J ] ． Chin J Obstet Gynecol ， 2022 ， 57 （ 4 ）： 244 - 252 ．

Li W ， Jiang Z ， Deng X ， et al . Long-term follow-up outcome and reintervention analysis of ultrasound-guided high intensity focused ultrasound treatment for uterine fibroids [J ] . Int J Hyperthermia ， 2020 ， 37 （ 1 ）： 1046 - 1051 ．

朱丽，陈文直，陈锦云，等 . 咪唑安定-芬太尼镇静镇痛在超声消融子宫肌瘤中的应用研究 [J ] . 重庆医科大学学报， 2009 ， 34 （ 11 ）： 556 - 1558 ．

Zhu L ， Chen WZ ， Chen JY ， et al . Response of conscious-sedation in ultrasound ablation for uterine fibroids [J ] . J Chongqing Med Univ ， 2009 ， 34 （ 11 ）： 556 - 1558 ．

Koltsova AS ， Pendina AA ， Malysheva OV ， et al . In vitro effect of estrogen and progesterone on cytogenetic profile of uterine leiomyomas [J ] . Int J Mol Sci ， 2024 ， 26 （ 1 ）： 96 ．

Sandberg EM ， Tummers FHMP ， Cohen SL ， et al . Reintervention risk and quality of life outcomes after uterine-sparing interventions for fibroids：a systematic review and meta-analysis [J ] . Fertil Steril ， 2018 ， 109 （ 4 ）： 698 - 707 .

Li W ， Yang Z ， Gao B ， et al . Comparison of ultrasound-guided high-intensity focused ultrasound ablation and hysteroscopic myomectomy for submucosal fibroids：a retrospective study [J ] . Int J Hyperthermia ， 2021 ， 38 （ 1 ）： 1609 - 1616 ．

Qin S ， Lin Z ， Liu N ， et al . Prediction of postoperative reintervention risk for uterine fibroids using clinical-imaging features and T2WI radiomics before high-intensity focused ultrasound ablation [J ] . Int J Hyperthermia ， 2023 ， 40 （ 1 ）： 2226847 ．

Ikink ME ， Nijenhuis RJ ， Verkooijen HM ， et al . Volumetric MR-guided high-intensity focused ultrasound versus uterine artery embolisation for treatment of symptomatic uterine fibroids：comparison of symptom improvement and reintervention rates [J ] . Eur Radiol ， 2014 ， 24 （ 10 ）： 2649 - 2657 ．

Li S ， Ma WW ， Yang MJ ， et al . Long-term re-intervention after USgHIFU and prediction of NPVR in different ages of patients with uterine fibroids [J ] . Int J Hyperthermia ， 2024 ， 41 （ 1 ）： 2304264 ．

Park MJ ， Kim YS ， Rhim H ， et al . Safety and therapeutic efficacy of complete or near-complete ablation of symptomatic uterine fibroid tumors by MR imaging-guided high-intensity focused US therapy [J ] . J Vasc Interv Radiol ， 2014 ， 25 （ 2 ）： 231 - 239 ．

范风云，吴晓东，沈婉婷，等 . 基于超声参数的延胡索酸水合酶缺陷型子宫平滑肌瘤预测模型的建立 [J/OL ] . 中华医学超声杂志（电子版）， 2025 ， 22 （ 9 ）： 868 - 875 .

Fan FY ， Wu XD ， Shen WT ， et al . Development of a prediction model for fumarate hydratase-deficient uterine leiomyoma based on ultrasonographic parameters [J/OL ] . Chin J Med Ultrasound（Electron Ed）， 2025 ， 22 （ 9 ）： 868 - 875 .

Qu DC ， Chen Y ， Yang MM ， et al . High-intensity focused ultrasound for treatment of type 2 submucous myomas more than 4 centimeters in diameter prior to hysteroscopic myomectomy [J ] . J Minim Invasive Gynecol ， 2020 ， 27 （ 5 ）： 1076 - 1080 ．

Xu J ， Tang W ， Lin L ， et al . Post treatment and 3 month contrast enhanced MRI findings following HIFU of submucosal fibroids：a retrospective study [J ] . Int J Hyperthermia ， 2023 ， 40 （ 1 ）： 2216897 ．

Liao WL ， Ying TH ， Shen HP ， et al . Combined treatment for big submucosal myoma with High Intensity Focused Ultrasound and hysteroscopic resection [J ] . J Obstet Gynecol ， 2019 ， 58 （ 6 ）： 888 - 890 ．

Paul PG ， Paul G ， Radhika KT ， et al . Laparoscopic myomectomy for a plethora of submucous myomas [J ] . J Minim Invasive Gynecol ， 2017 ， 24 （ 6 ）： 893 - 894 ．

Horton J ， Sterrenburg M ， Lane S ， et al . Reproductive，obstetric，and perinatal outcomes of women with adenomyosis and endometriosis：a systematic review and meta-analysis [J ] . Hum Reprod Update ， 2019 ， 25 （ 5 ）： 592 - 632 ．

Gong X ， Liu D ， Yang MJ ， et al . Tolerance and efficacy of HIFU ablation for uterine fibroids NPVR ≥ 90%：a nested case-control study [J ] . Int J Hyperth ， 2022 ， 39 （ 1 ）： 946 - 951 ．

Wei C ， Li NY ， Shi B ， et al . The predictive value of conventional MRI combined with radiomics in the immediate ablation rate of HIFU treatment for uterine fibroids [J ] . Int J Hyperth ， 2022 ， 39 （ 1 ）： 475 - 484 ．

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