Cargando…

Ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids

The aim of the present study was to investigate factors affecting ablation effect and safety of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for uterine fibroids (UFs). A retrospective analysis of 346 patients with symptomatic UFs who were treated with USgHIFU was performed. All UFs...

Descripción completa

Detalles Bibliográficos
Autores principales: Fan, Hong-Jie, Zhang, Chao, Lei, Hong-Tao, Cun, Jiang-Ping, Zhao, Wei, Huang, Jian-Qiang, Zhai, Yue
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417526/
https://www.ncbi.nlm.nih.gov/pubmed/30855440
http://dx.doi.org/10.1097/MD.0000000000014566
_version_ 1783403581586538496
author Fan, Hong-Jie
Zhang, Chao
Lei, Hong-Tao
Cun, Jiang-Ping
Zhao, Wei
Huang, Jian-Qiang
Zhai, Yue
author_facet Fan, Hong-Jie
Zhang, Chao
Lei, Hong-Tao
Cun, Jiang-Ping
Zhao, Wei
Huang, Jian-Qiang
Zhai, Yue
author_sort Fan, Hong-Jie
collection PubMed
description The aim of the present study was to investigate factors affecting ablation effect and safety of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for uterine fibroids (UFs). A retrospective analysis of 346 patients with symptomatic UFs who were treated with USgHIFU was performed. All UFs was grouped based on magnetic resonance imaging (MRI) characteristics before HIFU; all adverse events and treatment data were recorded during and after HIFU. One-way analysis of variance and multiple linear regression analysis were used to evaluate the effect of USgHIFU treatment and affecting factors. The results showed that the mean age of patients was 38.3 ± 6.1 years, with the mean nonperfusion volume rate of 74.4 ± 14.7% and the mean energy efficiency factor (EEF) of 7.2 ± 4.8 J/mm(3). Except for the size group, the ablation rate was significantly different (P < .001); and the anterior, intramural, hypointense (T2WI), and mild enhancement (T1WI contrast enhancement) UFs had the highest ablation rate. The EEF of the anterior, intramural, hypointense (T2WI), mild enhancement (T1WI contrast enhancement), and >5 cm UFs had minimum value, with a statistically significant difference (P < .01). According to multiple linear regression model, the distance from the UFs ventral side to the skin, enhancement type on T1WI, size of UFs, signal intensity on T2WI, location of UFs, type and volume of fibroids all had a line relationship with EEF, and the enhancement type on T1WI was the greatest factor affecting the ablation effect. Some patients (37.6%) had thermal injury of the sacrum on MRI, but no serious adverse events were observed. Our results suggest that USgHIFU can be safely used and have a promising prospect for treating UFs, even though its effect may be affected by anatomical features, tissue characteristics, and blood supply.
format Online
Article
Text
id pubmed-6417526
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-64175262019-03-16 Ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids Fan, Hong-Jie Zhang, Chao Lei, Hong-Tao Cun, Jiang-Ping Zhao, Wei Huang, Jian-Qiang Zhai, Yue Medicine (Baltimore) Research Article The aim of the present study was to investigate factors affecting ablation effect and safety of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for uterine fibroids (UFs). A retrospective analysis of 346 patients with symptomatic UFs who were treated with USgHIFU was performed. All UFs was grouped based on magnetic resonance imaging (MRI) characteristics before HIFU; all adverse events and treatment data were recorded during and after HIFU. One-way analysis of variance and multiple linear regression analysis were used to evaluate the effect of USgHIFU treatment and affecting factors. The results showed that the mean age of patients was 38.3 ± 6.1 years, with the mean nonperfusion volume rate of 74.4 ± 14.7% and the mean energy efficiency factor (EEF) of 7.2 ± 4.8 J/mm(3). Except for the size group, the ablation rate was significantly different (P < .001); and the anterior, intramural, hypointense (T2WI), and mild enhancement (T1WI contrast enhancement) UFs had the highest ablation rate. The EEF of the anterior, intramural, hypointense (T2WI), mild enhancement (T1WI contrast enhancement), and >5 cm UFs had minimum value, with a statistically significant difference (P < .01). According to multiple linear regression model, the distance from the UFs ventral side to the skin, enhancement type on T1WI, size of UFs, signal intensity on T2WI, location of UFs, type and volume of fibroids all had a line relationship with EEF, and the enhancement type on T1WI was the greatest factor affecting the ablation effect. Some patients (37.6%) had thermal injury of the sacrum on MRI, but no serious adverse events were observed. Our results suggest that USgHIFU can be safely used and have a promising prospect for treating UFs, even though its effect may be affected by anatomical features, tissue characteristics, and blood supply. Wolters Kluwer Health 2019-03-08 /pmc/articles/PMC6417526/ /pubmed/30855440 http://dx.doi.org/10.1097/MD.0000000000014566 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Fan, Hong-Jie
Zhang, Chao
Lei, Hong-Tao
Cun, Jiang-Ping
Zhao, Wei
Huang, Jian-Qiang
Zhai, Yue
Ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids
title Ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids
title_full Ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids
title_fullStr Ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids
title_full_unstemmed Ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids
title_short Ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids
title_sort ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417526/
https://www.ncbi.nlm.nih.gov/pubmed/30855440
http://dx.doi.org/10.1097/MD.0000000000014566
work_keys_str_mv AT fanhongjie ultrasoundguidedhighintensityfocusedultrasoundinthetreatmentofuterinefibroids
AT zhangchao ultrasoundguidedhighintensityfocusedultrasoundinthetreatmentofuterinefibroids
AT leihongtao ultrasoundguidedhighintensityfocusedultrasoundinthetreatmentofuterinefibroids
AT cunjiangping ultrasoundguidedhighintensityfocusedultrasoundinthetreatmentofuterinefibroids
AT zhaowei ultrasoundguidedhighintensityfocusedultrasoundinthetreatmentofuterinefibroids
AT huangjianqiang ultrasoundguidedhighintensityfocusedultrasoundinthetreatmentofuterinefibroids
AT zhaiyue ultrasoundguidedhighintensityfocusedultrasoundinthetreatmentofuterinefibroids