Safety and Efficacy of High Intensity Focused Ultrasound Ablation Therapy for Adenomyosis
Safety and Efficacy of High Intensity Focused Ultrasound Ablation Therapy for Adenomyosis
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DOI：
10.1016/j.acra.2009.06.005
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发表时间：
2009-11-01
影响因子：
4.8
通讯作者：
Tang, Jie
中科院分区：
文献类型：
--
作者：
Wang, Wei;Wang, Yuexiang;Tang, Jie
理由和目标。在子宫腺肌病患者中，症状的严重程度与子宫腺肌病的程度大致相关。因此，假设消融足够体积的子宫腺肌病可能会缓解症状。本研究的目的是探讨高强度聚焦超声（HIFU）消融治疗子宫腺肌病的安全性和有效性。对12例患者进行了I期HIFU消融治疗子宫腺肌病。分别使用四种不同的声强（290、340、380和420 W）逐步治疗三名患者。超声造影用于评估治疗后子宫腺肌病的坏死区域。随访3个月，评价治疗效果。4组患者均耐受良好，随访期间未发现严重并发症。治疗后，所有治疗的子宫腺肌病患者的超声造影均显示非增强的坏死区域。在290-W、340-W、380-W和420-W组中，非增强区域的平均体积分别为72、75、68和124 cm（3）。在治疗后3个月，四组的平均疼痛缓解率分别为25%、58.3%、66.7%和83.3%。HIFU治疗子宫腺肌症是一种安全有效的方法，420 W的声强可以产生更大体积的坏死和更好的疼痛缓解。
Rationale and Objectives. In patients with adenomyosis, the severity of symptoms correlates roughly with the extent of adenomyosis. Thus, it was hypothesized that the ablation of enough volume of adenomyosis might alleviate symptoms. The aim of this study was to investigate the safety and efficacy of high-intensity focused ultrasound (HIFU) ablation for the treatment of adenomyosis.Materials and Methods. Phase I HIFU ablation of adenomyosis was performed on 12 patients. Three patients each were treated using four different acoustic intensities (290, 340, 380, and 420 W) step by step. Contrast-enhanced ultrasound was used to evaluate the necrotic region of treated adenomyosis. The efficacy of therapy was evaluated after 3 months of follow-up.Results. All patients in the four groups tolerated the therapy well, and no severe complications were found during follow-up. After treatment, nonenhanced necrotic regions were shown on contrast-enhanced ultrasound in all treated adenomyosis. The mean volumes of the nonenhanced regions were 72, 75, 68, and 124 cm(3) in the 290-W, 340-W, 380-W, and 420-W groups, respectively. At 3 months after therapy, the mean pain relief in the four groups was 25%, 58.3%, 66.7%, and 83.3%, respectively.Conclusions. HIFU may be a safe and effective method to treat adenomyosis, and an acoustic intensity of 420 W may be able to produce larger volumes of necrosis and better pain relief.