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：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

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

1.	陈文直, 唐良萏, 杨武威, 等. 超声消融治疗子宫肌瘤的安全性及有效性[J]. 中华妇产科杂志, 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.	杨武威, 祝宝让, 李静, 等. 超声消融治疗子宫肌瘤的近期并发症及其影响因素分析[J]. 中华妇产科杂志, 2010, 45(12):913-916.
4.	姜曼, 赵卫, 姚瑞红,等. 高强度聚焦超声消融治疗子宫肌瘤的临床应用[J]. 介入放射学杂志, 2013, 22(1):82-85.
5.	谢幸, 苟文丽, 林仲秋, 等. 妇产科学[M]. 人民卫生出版社, 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, 陈锦云, 李志红, 等. 比较子宫切除术式对生活质量的影响[J]. 中国妇幼健康研究, 2008, 19(1):30-32.
8.	邹建中, 欧霞. 高强度聚焦超声的剂量学研究进展[J]. 科技导报, 2010, 28(21):95-100.
9.	杨武威, 盖绿华, 李静, 等. 高强度聚焦超声消融子宫肌瘤的MRI评价[J]. 解放军医学杂志, 2009, 34(5):616-618.
10.	姜曼, 华媛媛, 周敏, 等. 高强度聚焦超声治疗子官肌瘤的有效性和影像学特征分析[J]. 解放军医学杂志, 2014, 39(3):212-216.
11.	姜曼, 赵卫, 易根发, 等. 子宫肌瘤MRI特征与高强度聚焦超声消融疗效[J]. 介入放射学杂志, 2014, 23(4):314-319.
12.	王婷, 陈文直, 陈锦云, 等. 聚焦超声消融不同MRI图像表现的子宫肌瘤的疗效[J]. 重庆医科大学学报, 2011, 36(5):539-541.
13.	侯静, 刘晟, 王维, 等. MRI T2WI信号强度与高强度聚焦超声消融子宫肌瘤疗效关系的研究[J]. 医学影像学杂志, 2014, 24(5):820-823.
14.	陈锦云, 陈文直, 朱丽, 等. 子宫肌瘤的血液供应特征对超声消融治疗剂量的影响[J]. 中华妇产科杂志, 2011, 46(6):403-406.
15.	赵敬生, 党蓉芳, 孙平, 等. 预防高强度聚焦超声治疗并发症的操作技巧[J]. 吉林医学, 2013, 34(26):5404-5406.

1. 陈文直, 唐良萏, 杨武威, 等. 超声消融治疗子宫肌瘤的安全性及有效性[J]. 中华妇产科杂志, 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. 杨武威, 祝宝让, 李静, 等. 超声消融治疗子宫肌瘤的近期并发症及其影响因素分析[J]. 中华妇产科杂志, 2010, 45(12):913-916.
4. 姜曼, 赵卫, 姚瑞红,等. 高强度聚焦超声消融治疗子宫肌瘤的临床应用[J]. 介入放射学杂志, 2013, 22(1):82-85.
5. 谢幸, 苟文丽, 林仲秋, 等. 妇产科学[M]. 人民卫生出版社, 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, 陈锦云, 李志红, 等. 比较子宫切除术式对生活质量的影响[J]. 中国妇幼健康研究, 2008, 19(1):30-32.
8. 邹建中, 欧霞. 高强度聚焦超声的剂量学研究进展[J]. 科技导报, 2010, 28(21):95-100.
9. 杨武威, 盖绿华, 李静, 等. 高强度聚焦超声消融子宫肌瘤的MRI评价[J]. 解放军医学杂志, 2009, 34(5):616-618.
10. 姜曼, 华媛媛, 周敏, 等. 高强度聚焦超声治疗子官肌瘤的有效性和影像学特征分析[J]. 解放军医学杂志, 2014, 39(3):212-216.
11. 姜曼, 赵卫, 易根发, 等. 子宫肌瘤MRI特征与高强度聚焦超声消融疗效[J]. 介入放射学杂志, 2014, 23(4):314-319.
12. 王婷, 陈文直, 陈锦云, 等. 聚焦超声消融不同MRI图像表现的子宫肌瘤的疗效[J]. 重庆医科大学学报, 2011, 36(5):539-541.
13. 侯静, 刘晟, 王维, 等. MRI T2WI信号强度与高强度聚焦超声消融子宫肌瘤疗效关系的研究[J]. 医学影像学杂志, 2014, 24(5):820-823.
14. 陈锦云, 陈文直, 朱丽, 等. 子宫肌瘤的血液供应特征对超声消融治疗剂量的影响[J]. 中华妇产科杂志, 2011, 46(6):403-406.
15. 赵敬生, 党蓉芳, 孙平, 等. 预防高强度聚焦超声治疗并发症的操作技巧[J]. 吉林医学, 2013, 34(26):5404-5406.

West China Medical Journal

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

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content