Curative Effect Observation on High-intensity Focused Ultrasound Treatment for Uterine Fibroids_West China Medical Journal

Authors：

 ZHAOJing-sheng ¹ ,  HULong-fei ² , ZHANGXiang-yang ³ , ZHAOBao-ping ³ , DANGRong-fang ⁴ , XUEXiao-ling ⁴

1. HIFU Center, Maternal and Child Health Care Hospital, Baoji, Shaanxi 721000, P. R. China;
2. Imaging Department, Maternal and Child Health Care Hospital, Baoji, Shaanxi 721000, P. R. China;
3. Imaging Department, PLA 537 Hospital, Baoji, Shaanxi 721000, P. R. China;
4. Department of Gynecology, Maternal and Child Health Care Hospital, Baoji, Shaanxi 721000, P. R. China;

Corresponding?author：

HULong-fei, Email: zhaojsyj@126.com

Keywords：

Uterine fibroids; High-intensity focused ultrasound; Curative effect

DOI：

10.7507/1002-0179.20150646

Video：

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Objective To probe into the clinical efficacy of high-intensity focused ultrasound (HIFU) alone for uterine fibroids. Method Between February 2012 and February 2014, 145 patients with 174 cases of uterine fibroids were treated with HIFU. Before and one day, 6 months, 12 months after treatment, MRI was performed during the follow-up. We analyzed fibroids narrowing rate, adverse reactions, and clinical symptoms improvement after treatment. Results Successful completion of HIFU ablation was done for all the fibroids. Enhanced MRI examination before and one day after treatment, and MRI plain scanning 6 and 12 months after treatment showed that fibroid volume before treatment was 4.61-419.70 cm³ (median of 56.82 cm³), fibroid volume after treatment was 3.02-578.21 cm³ (median of 56.74 cm³), ablation volume was 2.42-578.21 cm³ (median of 47.84 cm³), and volumetric ablation rate was 24%-100%; there was no statistically significant difference in fibroid volume before and after treatment (P>0.05); fibroid volume 6 months after treatment was 0-264.50 cm³ (median of 22.49 cm³) and was 0-346.02 cm³ (median of 14.81 cm³) 12 months after treatment with a reduction rate of 60.4% and 73.9% on average respectively, and the volume was significantly different between those two time points and before treatment (P<0.05), and between 6 months and 12 months after treatment (P<0.05). The medians of uterine fibroid symptoms (UFS) and quality of life (QOL) scores before ablation were respectively 21.88 and 71.55 points. UFS reduced by 57.1% and 71.4% respectively 6 and 12 months after ablation, and QOL increased by 15.7% and 26.5% at those two time points. Both UFS and QOL 6 and 12 months after treatment were significantly different from that before treatment (P<0.05), and the UFS and QOL difference between 6 months and 12 months after treatment was also significant (P<0.05). As time went on, UFS gradually reduced, while QOL gradually increased. Complication rate was 2.8% with two cases of skin shallow degree-Ⅱ thermal damage, one of lower limb radiation pain, one of urinary retention, and there were 6 cases of recurrence during the follow-up. Conclusions HIFU treatment for uterine fibroids is safe and effective, and is an alternative choice for conventional treatment when it is unable to retain the womb or when the patient refuses surgical treatment.

Citation： ZHAOJing-sheng, HULong-fei, ZHANGXiang-yang, ZHAOBao-ping, DANGRong-fang, XUEXiao-ling. Curative Effect Observation on High-intensity Focused Ultrasound Treatment for Uterine Fibroids. West China Medical Journal, 2015, 30(12): 2254-2257. doi: 10.7507/1002-0179.20150646 Copy

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9.	楊武威, 蓋綠華, 李靜, 等. 高強度聚焦超聲消融子宮肌瘤的MRI評價[J]. 解放軍醫學雜志, 2009, 34(5):616-618.
10.	姜曼, 華媛媛, 周敏, 等. 高強度聚焦超聲治療子官肌瘤的有效性和影像學特征分析[J]. 解放軍醫學雜志, 2014, 39(3):212-216.
11.	姜曼, 趙衛, 易根發, 等. 子宮肌瘤MRI特征與高強度聚焦超聲消融療效[J]. 介入放射學雜志, 2014, 23(4):314-319.
12.	王婷, 陳文直, 陳錦云, 等. 聚焦超聲消融不同MRI圖像表現的子宮肌瘤的療效[J]. 重慶醫科大學學報, 2011, 36(5):539-541.
13.	侯靜, 劉晟, 王維, 等. MRI T2WI信號強度與高強度聚焦超聲消融子宮肌瘤療效關系的研究[J]. 醫學影像學雜志, 2014, 24(5):820-823.
14.	陳錦云, 陳文直, 朱麗, 等. 子宮肌瘤的血液供應特征對超聲消融治療劑量的影響[J]. 中華婦產科雜志, 2011, 46(6):403-406.
15.	趙敬生, 黨蓉芳, 孫平, 等. 預防高強度聚焦超聲治療并發癥的操作技巧[J]. 吉林醫學, 2013, 34(26):5404-5406.

1. 陳文直, 唐良萏, 楊武威, 等. 超聲消融治療子宮肌瘤的安全性及有效性[J]. 中華婦產科雜志, 2010, 45(12):909-912.
2. Zhang L, Chen WZ, Liu YJ, et al. Feasibility of magnetic resonance imaging-guided high intensity focused ultrasound therapy for ablating uterine fibroids in patients with bowel lies anterior to uterus[J]. Eur J Radiol, 2010, 73(2):396-403.
3. 楊武威, 祝寶讓, 李靜, 等. 超聲消融治療子宮肌瘤的近期并發癥及其影響因素分析[J]. 中華婦產科雜志, 2010, 45(12):913-916.
4. 姜曼, 趙衛, 姚瑞紅,等. 高強度聚焦超聲消融治療子宮肌瘤的臨床應用[J]. 介入放射學雜志, 2013, 22(1):82-85.
5. 謝幸, 茍文麗, 林仲秋, 等. 婦產科學[M]. 人民衛生出版社, 2014:310-313.
6. Hricak H, Tscholakoff D, Heinrichs L, et al. Uterine leiomyomas:correlation of Mr, histopathologic findings, and symptoms[J]. Radiology, 1986, 158(2):385-391.
7. 冀振芬, 陳錦云, 李志紅, 等. 比較子宮切除術式對生活質量的影響[J]. 中國婦幼健康研究, 2008, 19(1):30-32.
8. 鄒建中, 歐霞. 高強度聚焦超聲的劑量學研究進展[J]. 科技導報, 2010, 28(21):95-100.
9. 楊武威, 蓋綠華, 李靜, 等. 高強度聚焦超聲消融子宮肌瘤的MRI評價[J]. 解放軍醫學雜志, 2009, 34(5):616-618.
10. 姜曼, 華媛媛, 周敏, 等. 高強度聚焦超聲治療子官肌瘤的有效性和影像學特征分析[J]. 解放軍醫學雜志, 2014, 39(3):212-216.
11. 姜曼, 趙衛, 易根發, 等. 子宮肌瘤MRI特征與高強度聚焦超聲消融療效[J]. 介入放射學雜志, 2014, 23(4):314-319.
12. 王婷, 陳文直, 陳錦云, 等. 聚焦超聲消融不同MRI圖像表現的子宮肌瘤的療效[J]. 重慶醫科大學學報, 2011, 36(5):539-541.
13. 侯靜, 劉晟, 王維, 等. MRI T2WI信號強度與高強度聚焦超聲消融子宮肌瘤療效關系的研究[J]. 醫學影像學雜志, 2014, 24(5):820-823.
14. 陳錦云, 陳文直, 朱麗, 等. 子宮肌瘤的血液供應特征對超聲消融治療劑量的影響[J]. 中華婦產科雜志, 2011, 46(6):403-406.
15. 趙敬生, 黨蓉芳, 孫平, 等. 預防高強度聚焦超聲治療并發癥的操作技巧[J]. 吉林醫學, 2013, 34(26):5404-5406.

West China Medical Journal

Curative Effect Observation on High-intensity Focused Ultrasound Treatment for Uterine Fibroids

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