[1]李 兵,袁冬存.基于MR T2加权成像影像组学预测子宫动脉栓塞术治疗子宫腺肌病中近期效果初步研究[J].介入放射学杂志,2025,34(11):1191-1196.[doi:10.3969/j.issn.1008-794X.2025.11.005]
　LI Bing,YUAN Dongcun..Prediction of the short-term efficacy of uterine artery embolization for the treatment of uterus adenomyosis based on MR T2 weighted imaging radiomics:a preliminary study[J].J Intervent Med,2025,34(11):1191-1196.[doi:10.3969/j.issn.1008-794X.2025.11.005]
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基于MR T2加权成像影像组学预测子宫动脉栓塞术治疗子宫腺肌病中近期效果初步研究()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
34
期数:
2025年11
页码:
1191-1196
栏目:
血管介入
出版日期:
2025-11-25

文章信息/Info

Title:
Prediction of the short-term efficacy of uterine artery embolization for the treatment of uterus adenomyosis based on MR T2 weighted imaging radiomics:a preliminary study
文章编号:
1008-794X(2025)-011-1191-06
作者:
李 兵;  袁冬存
230001 安徽合肥 安徽省妇女儿童医学中心放射介入科
Author(s):
LI Bing; YUAN Dongcun.
Department of Interventional Radiology,Anhui Provincial Women and Children Medical Center,Hefei,Anhui Province 230001,China
关键词:
子宫腺肌病;  子宫动脉栓塞术;  疗效预测;  磁共振T2影像组学
分类号:
R711.74
DOI:
10.3969/j.issn.1008-794X.2025.11.005
文献标志码:
A
摘要:
目的 探讨基于MR T2加权成像(T2WI)影像组学方法预测子宫动脉栓塞术(uterine artery embolization,UAE)治疗子宫腺肌病的中近期效果。方法 回顾性分析140例初次接受UAE术治疗的子宫腺肌病患者。术前1周内行盆腔MR检查,术后6、12个月随访盆腔MR。根据子宫腺肌病病情缓解标准评价UAE术后疗效。采用分层抽样法按7:3比例将患者分成训练组(n=98)和测试组(n=42)。根据治疗反应将患者分为治疗有效组(n=101)和无效组(n=39)。使用ITK-SNAP软件在术前T2WI图像上勾画病变区域,提取影像组学特征。采用单因素分析、最小绝对收缩和选择算子回归法筛选影像组学特征并建立影像组学模型。采用受试者工作特征曲线(ROC)评估影像组学模型对子宫腺肌病UAE治疗后无效的预测效能,并计算曲线下面积(AUC)。采用决策曲线分析评价模型的临床实用价值。结果 9个最优影像组学特征纳入预测模型。模型预测训练组、测试组患者UAE治疗后无效的AUC分别为0.838(95%CI=0.751～0.924)、0.817(95%CI=0.677～0.954)。决策曲线分析显示,影像组学模型具有较高的临床净效益。结论 基于MR T2WI影像组学模型可有效预测UAE治疗子宫腺肌病中近期效果,有助于早期识别治疗无效风险,及时调整治疗策略。

参考文献/References:

[1] Kho KA,Chen JS,Halvorson LM.Diagnosis,evaluation,and treatment of adenomyosis[J].JAMA,2021,326:177-178.
[2]Chen J,Porter AE,Kho KA.Current and future surgical and interventional management options for adenomyosis[J].Semin Reprod Med,2020,38:157-167.
[3]王世宣,崔鹏飞,张金金.子宫腺肌病三级管理专家共识[J].实用妇产科杂志,2024,40:106-111.
Wang SX,Cui PF,Zhang JJ.Expert Consensus on the Three-level Management of Adenomyosis[J].JPOG,2024,40:106-111.
[4]中国医师协会妇产科医师分会子宫内膜异位症专业委员会.子宫腺肌病诊治中国专家共识[J].中华妇产科杂志,2020,55:376-383.
Endometriosis Professional Committee of Obstetricians and Gynecologists Branch of Chinese Medical Doctor Association[J].Chin J Obstet Gynecol,2020,55:376-383.
[5]郎景和,陈春林,向 阳,等.子宫肌瘤及子宫腺肌病子宫动脉栓塞术治疗专家共识[J].中华妇产科杂志,2018,53:289-293.
Lang JH,Chen CL,Xiang Y,et al.Expert consensus on the treatment of uterine artery embolization of uterine fibroids and adenomyosis[J].Chin J Obstet Gynecol,2018,53:289-293.
[6]郑 睿,曾 丹,万婷婷,等.预测子宫腺肌症动脉栓塞后病灶治疗应答的多因素logistic回归分析[J].影像诊断与介入放射学,2018,27:96-102.
Zheng R,Zeng D,Wan TT,et al.Multivariate logistic return analysis for predicting the treatment response of lesions after adenomyosis arterial embolization[J].Imaging Diagn Interv Radiol,2018,27:96-102.
[7]Liu S,Peng C,Wang Z,et al.Association of normalization of postoperative carbohydrate antigen 125 levels with treatment failure following uterine artery embolization for adenomyosis[J].J Obstet Gynaecol Res,2023,49:2753-2760.
[8]鲁景元,刘 旸,徐文健.子宫动脉栓塞治疗症状性子宫腺肌病中长期疗效[J].中国介入影像与治疗学,2022,19:683-686.
Lu JY,Liu Y,Xu WJ.Medium and long-term efficacy of uterine artery embolization in the treatment of symptomatic adenomyosis[J].Chin J Intervent Imaging Ther,2022,19:683-686.
[9]Guo W,Hu S,Zeng D,et al.The prognostic role of ovarian endometriosis in symptomatic adenomyosis patients underwent uterine artery embolization[J].Ann Palliat Med,2021,10:2577-2583.
[10]Kobayashi H,Matsubara S,Imanaka S.Relationship between magnetic resonance imaging-based classification of adenomyosis and disease severity[J].J Obstet Gynaecol Res,2021,47:2251-2260.
[11]Pausch AM,Fillebock V,Benli M,Witzel I,Hötker AM.MRI of pelvic endometriosis:evaluation of the mr#Enzian classification and the importance of adenomyosis subtypes[J].Abdom Radiol(NY),2024,49:3241-3250.
[12]Zhang M,Bazot M,Tsatoumas M,et al.MRI of adenomyosis:where are we today?[J].Can Assoc Radiol J,2023,74:58-68.
[13]Guo WB,Hu SQ,Wan TT,et al.Preoperative MRI classification may not predict symptom relief after uterine artery embolization in patients with adenomyosis[J].Curr Med Sci,2021,41:1252-1256.
[14]刘 臻,刘笑默.MRI在不同栓塞策略UAE治疗子宫腺肌症术后效果的评价[J].中国临床医学影像杂志,2023,34:741-744.
Liu Z,Liu XM.Evaluation of the postoperative effect of MRI in the treatment of adenomyosis with UAE with different embolization strategies[J].Chin J Clin Med Imaging,2023,34:741-744.
[15]高兴波,丁 锋,吴 明.MRI用于子宫腺肌病患者微球介入治疗后疗效评价的价值[J].临床放射学杂志,2021,40:2371-2378.
Gao XB,Ding F,Wu M.The value of MRI for the evaluation of the efficacy of microsphere intervention in patients with adenomyosis[J].J Clin Radiol,2021,40:2371-2378.
[16]Turtoczki K,Cho H,Dastaran S,et al.Evaluation of junctional zone differential and ratio as possible markers of clinical efficacy in uterine artery embolisation of adenomyosis[J].CVIR Endovasc,2024; 7:55.
[17]王 申,李 红,王 曦,等.影像组学在肝细胞癌TACE中的应用进展[J].介入放射学杂志,2022,31:829-832.
Wang S,Li H,Wang X,et al.Advances in the application of radiomics in TACE of hepatocellular carcinoma[J].J Interv Radiol,2022,31:829-832.
[18]朱帆东,杨 晨,赵振华.影像组学对评估肿瘤微波/射频消融疗效预后的研究进展[J].介入放射学杂志,2024,33:693-696.
Zhu Fd,Yang C,Zhao Zh.Research progress of radiomics on evaluating the efficacy and prognosis of tumor microwave/radiofrequency ablation[J].J Interv Radiol,2024,33:693-696.
[19]Li Z,Zhang J,Song Y,et al.Utilization of radiomics to predict long-term outcome of magnetic resonance-guided focused ultrasound ablation therapy in adenomyosis[J].Eur Radiol,2021,31:392-402.
[20]Liu Z,Liu Z,Wan X,et al.Predicting high-intensity focused ultrasound efficacy in adenomyosis treatment based on magnetic resonance(MR)radiomics and clinical-imaging features[J].Clin Radiol,2025,81:106778.
[21]Jin W,Wang S,Wang T,et al.Multi-machine learning model based on habitat subregions for outcome prediction in adenomyosis treated by uterine artery embolization[J].Acad Radiol,2024,31:4985-4995.
[22]Jin WT,Zhang GF,Wang TP,et al.Nomogram for predicting the long-term outcomes of uterine artery embolization for adenomyosis[J].Eur J Radiol,2022,148:110183.
(收稿日期:2025-02-09)
(本文编辑:谷 珂)

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　XIE Xuancheng,FAN Hongjie,ZHAO Wei,et al.Interventional treatment of uterine fibroids： its current situation and research progress[J].J Intervent Med,2019,28(11):905.
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备注/Memo

备注/Memo:
通信作者: 李 兵 E-mail:zgfyjr@163.com
更新日期/Last Update: 2025-11-25