Contrast-enhanced ultrasound for evaluation of high-intensity focused ultrasound treatment of benign uterine diseases: retrospective analysis of contrast safety.
Contrast-enhanced ultrasound for evaluation of high-intensity focused ultrasound treatment of benign uterine diseases: retrospective analysis of contrast safety.
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DOI：
10.1097/md.0000000000000729
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发表时间：
2015-04
期刊：
影响因子：
1.6
通讯作者：
Bai J
中科院分区：
文献类型：
--
作者：
Cheng CQ;Zhang RT;Xiong Y;Chen L;Wang J;Huang GH;Li KQ;Zhang L;Bai J
超声引导下高强度聚焦超声（HIFU）作为一种无创治疗技术，在我国已被认为是子宫肌瘤和子宫腺肌病的常规治疗方法。对比增强超声（CEUS）已被提议作为另一种选择，以评估在HIFU治疗的治疗效果。本研究的目的是评价一组使用超声造影剂（UCA）的患者与一组未暴露于UCA的患者进行HIFU消融治疗良性子宫疾病的不良反应。2010年11月至2013年12月，2604例子宫良性疾病患者接受了HIFU治疗。其中，1300例患者暴露于UCA，而1304例患者未暴露。在HIFU治疗过程中，暴露于SonoVue的患者的腿部疼痛、骶/背部疼痛、腹股沟疼痛、治疗区域疼痛和皮肤不适“热”感的发生率较高（Bravaldi，Milan，意大利）比那些没有（分别为20.5%对11.7%、52.5%对42.3%、6.5%对4.5%、68.9%对55.4%和48.1%对42.9%）。术后不良反应中，有UCA的患者下腹部疼痛发生率明显高于无UCA的患者（51.2%比39.9%，P <0.05）。 2例暴露于UCA的患者发生急性肾功能衰竭。总之，UCA可能会增加HIFU治疗良性子宫疾病过程中一些常见的HIFU相关不良反应的发生率，但大多数不良反应是可接受的和自限性的。对于有高血压病史或服用非甾体类抗炎药的患者，HIFU治疗后应监测肾功能。
As a noninvasive treatment technique, ultrasound-guided high-intensity focused ultrasound (HIFU) has been considered as a routine treatment for uterine fibroids and adenomyosis in China. Contrast-enhanced ultrasound (CEUS) has been proposed as another option to assess the treatment efficacy during HIFU treatment. The aim of this investigation is to evaluate the adverse effects of HIFU ablation for benign uterine diseases in a group of patients studied with ultrasound contrast agent (UCA), in comparison with a group of patients not exposed to UCA. From November 2010 to December 2013, 2604 patients with benign uterine diseases were treated with HIFU. Among them, 1300 patients were exposed to an UCA, whereas 1304 patients were not. During HIFU procedure, the incidences of leg pain, sacral/buttock pain, groin pain, treatment area pain, and the discomfort “hot” sensation on skin were higher in the patients who were exposed to SonoVue (Bracco, Milan, Italy) than those who were not (20.5% vs 11.7%, 52.5% vs 42.3%, 6.5% vs 4.5%, 68.9% vs 55.4%, and 48.1% vs 42.9%, respectively). Among the postoperative adverse effects, the incidence of lower abdominal pain was significantly higher in patients who were exposed to an UCA than those who were not (51.2% vs 39.9%, P < 0.05). Two patients who were exposed to an UCA had acute renal function failure. In conclusion, UCA may increase the incidences of some common HIFU-related adverse effects during HIFU treatment for benign uterine diseases, but most of which were acceptable and self-limited. After HIFU treatment, renal function should be monitored in patients with a history of hypertension or taking nonsteroidal anti-inflammatory drugs.