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Eur Radiol. 2012 Nov;22(11):2553-8. doi: 10.1007/s00330-012-2517-z. Epub 2012 Jun 1.

Safety and efficacy of US-guided high-intensity focused ultrasound for treatment of submucosal fibroids.

Author information

1
Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. wangw1016@yahoo.com.cn

Abstract

OBJECTIVES:

To evaluate the safety and efficacy of US-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of submucosal fibroids

METHODS:

A total of 76 women with 78 submucosal uterine fibroids (68 type II fibroids, 10 type I fibroids) underwent US-guided HIFU ablation. The pretreatment fibroid diameter ranged from 2.4 to 13.5 cm (mean 5.7 ± 2.3 cm). The fibroids were ablated using a power output of 420-520 W. During follow-up, the volume shrinkage of the ablated fibroids was continuously observed on contrast-enhanced MR and/or contrast-enhanced ultrasound (CEUS). The change of symptoms was evaluated by using the symptom severity score questionnaire.

RESULTS:

HIFU ablation was well tolerated in all patients. No major complications occurred. The mean nonperfused ablation ratio was 80 ± 12 % on CEUS. During follow-up, the ablated fibroids shrank significantly over time. The symptoms were alleviated significantly. No patients had amenorrhoea after treatment. Vaginal expulsion of necrotic tissue was seen in 58 % (44/76) of patients after HIFU ablation which disappeared after 2-4 menstrual cycles. Four patients received repeated HIFU ablation for enlarged residual fibroids.

CONCLUSIONS:

US-guided HIFU ablation may be a safe and effective treatment for submucosal fibroids. Further studies are warranted to observe its influence on fertility.

KEY POINTS :

• High-intensity focused ultrasound (HIFU) is a new minimally invasive therapeutic technique. • HIFU ablation may be safe and effective for treatment of submucosal fibroids • Treatment is minimally invasive and repeatable. • Vaginal expulsion of necrotic tissue is common after treatment.

PMID:
22653287
DOI:
10.1007/s00330-012-2517-z
[Indexed for MEDLINE]

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