Ultrasound guided high-intensity focused ultrasound combined with gonadotropin releasing hormone analogue (GnRHa) ablating uterine leiomyoma with homogeneous hyperintensity on T2 weighted MR imaging

作者：Yang, Shenghua; Kong, Fanjing; Hou, Ruijie; Rong, Fengmei; Ma, Nana; Li, Shaoping; Yang, Jun^*

来源：British Journal of Radiology, 2017, 90(1073): 20160760.

DOI：10.1259/bjr.20160760

• FIBROIDS
• SURGERY
• THERAPY

Objective: The study aimed to evaluate the safety and efficiency of ultrasound-guided high-intensity focused ultrasound (USgHIFU) combined with gonadotropin-releasing hormone analogue (GnRHa)-ablating symptomatic uterine leiomyoma with homogeneous hyperintensity on T-2 weighted MRI prospectively. @@@ Methods: A total of 34 patients with 42 symptomatic uterine leiomyomas with homogeneous hyperintensity on T-2 weighted MRI were enrolled in our study. In the patient who had multiple uterine leiomyomas, only one dominant leiomyoma was treated. According to the principles of voluntariness, 18 patients underwent a 3-month therapy of GnRHa (once a month) before the high-intensity focused ultrasound (HIFU) treatment, while 16 patients received only HIFU treatment. Enhanced MRI was performed before and after GnRHa and HIFU treatment. Evaluation of the main indicators included treatment time, sonication time, treatment efficiency, non-perfused volume (NPV) (indicative of successful ablation) ratio and energy effect ratio; adverse events were also recorded. @@@ Results: The treatment time and sonication time of the combination group were 102.0 min (55.8-152.2 min) and 25.4 min (12.2-34.1 min); however, they were 149.0 min (87.0-210.0 min) and 38.9 min (14.0-46.7 min) in the simple USgHIFU group. The treatment and sonication time for the combination group was significantly shorter than that for the simple USgHIFU group. Treatment efficiency, NPV ratio and energy effect ratio were 46.7mm(3) s(-1) (28.5-95.8mm(3) s(-1)), 69.2 +/- 29.8% (35.5-97.4%) and 9.9KJmm(-3) (4.5-15.7KJmm(-3)) in the combination group, respectively; but, the lowest treatment efficiency, lowest NPV ratio and more energy effect ratio were observed in the simple HIFU group, which were 16.8mm(3) s(-1) (8.9-32.9mm3 s(-1)), 50.2 +/- 27.3% (0-78.6%) and 23.8KJmm(-3) (12.4-46.2KJmm(-3)), respectively. Pain scores in the combination group were 3.0 +/- 0.5 points (2-4 points)-significantly less than the simple USgHIFU group. There were no significant adverse reactions in either group. @@@ Conclusion: Our data suggest that USgHIFU combined with GnRHa may be performed to ablate symptomatic uterine leiomyoma with homogeneous hyperintensity on T-2 weighted MRI.

• 出版日期2017
• 单位新乡医学院