多层高强度聚焦超声无创减少副乳腺脂肪的定量超声研究
前瞻性研究纳入30例BMI≥27 kg/m²的副乳腺脂肪女性，单次HIFU治疗（多焦深4.5/6.0/9.0 mm，频率4/2 MHz，能量1.5-2.0 J/点），28例完成8周随访。超声测得皮下脂肪厚度从基线19.2±3.4 mm降至8周15.8±3.1 mm，平均减少3.4±1.6 mm（17.7%），差异有统计学意义（95%CI 2.8-4.0 mm，p=1.1×10⁻¹¹）。所有参与者GAIS改善且满意度高，无严重不良事件。
要点
- HIFU可无创减少副乳腺脂肪厚度，8周平均减少3.4 mm（17.7%）。
- 超声是评估副乳腺脂肪厚度及疗效的可靠定量工具。
- 不良反应轻微短暂，无皮肤烧伤等严重事件。
关键影像表现/征象
- 副乳腺区皮下脂肪厚度超声测量基线为19.2±3.4 mm，8周降至15.8±3.1 mm。
- 平均配对减少量为3.4±1.6 mm（17.7%），95%CI 2.8-4.0 mm，p=1.1×10⁻¹¹。
- 所有参与者GAIS评分改善，患者满意度高。
- 不良反应包括短暂热不适和局部红斑，数小时至2天内消退，无皮肤烧伤。
诊断标准与关键数值
- 疗效评估以超声测量皮下脂肪厚度变化为主要指标，8周平均减少3.4±1.6 mm（17.7%），95%CI 2.8-4.0 mm，p=1.1×10⁻¹¹。
- 次要指标为研究者评定的GAIS和患者满意度评分，所有参与者GAIS改善。
临床应用与阅片要点
- 超声可用于副乳腺脂肪厚度的基线评估和HIFU疗效随访。
- 阅片时注意识别副乳腺区皮下脂肪层，测量厚度并记录。
- HIFU治疗后短期可能出现局部红斑和热不适，需与感染或烧伤鉴别。
局限性
- 样本量较小（30例入组，28例完成随访）。
- 单中心前瞻性研究，缺乏对照组。
- 随访时间仅8周，长期效果未知。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
OBJECTIVES: Accessory breast tissue often presents as localized axillary subcutaneous fullness, presenting as a palpable soft-tissue bulge composed of adipose or glandular elements, causing mechanical discomfort and esthetic concern. While surgical excision remains effective, it ma result in scarring, postoperative pain, and risks of seroma/hematoma or contour irregularity, leading to growing interest in noninvasive approaches. The objective of the study is to investigate the effect of noninvasive high-intensity focused ultrasound (HIFU) on subcutaneous fat thickness in axillary accessory breast tissue.
METHODS: This prospective study enrolled 30 women with BMI ≥27 kg/m2 and accessory breast fat. All participants underwent a single HIFU session using multiple focal depths of 4.5, 6.0, and 9.0 mm at operating frequencies of 4 and 2 MHz, with energy settings of 1.5-2.0 J per shot. Fat thickness was measured by ultrasound at baseline and 8 weeks. Secondary outcomes included investigator-rated Global Aesthetic Improvement Scale (GAIS) and patient satisfaction scores.
RESULTS: Among the 28 participants who completed the 8-week follow-up, mean subcutaneous fat thickness decreased from 19.2 ± 3.4 mm at baseline to 15.8 ± 3.1 mm at 8 weeks. The mean paired reduction was 3.4 ± 1.6 mm (17.7%), which was statistically significant (95% CI, 2.8-4.0 mm; p = 1.1 × 10⁻¹¹). All participants showed GAIS improvement with high satisfaction. No serious adverse events were observed; mild and transient effects included transient thermal discomfort and localized erythema resolving within several hours to 2 days, and no cases of skin burn were identified.
CONCLUSION: Non-invasive HIFU produced a measurable reduction of accessory breast fat with favorable esthetic outcomes and an acceptable safety profile.
引用
- Yi KH, Park Y, Sydorchuk O, et al. Non-invasive Reduction of Accessory Breast Fat Using Multilayer High-Intensity Focused Ultrasound: A Quantitative Ultrasound-Based Study. J Ultrasound Med. 2026. PMID: 42104539. doi:10.1002/jum.70238
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。