Impact on treatment safety and efficacy of seromuscular-layer injury after HIFU ablation for uterine fibroids
10.13929/j.1672-8475.201810038
- Author:
Qing WEI
1
Author Information
1. College of Biomedical Engineering, Chongqing Medical University, State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine
- Publication Type:Journal Article
- Keywords:
High-intensity focused ultrasound ablation;
Magnetic resonance imaging;
Myoma;
Seromuscular-layer injury;
Uterine neoplasms
- From:
Chinese Journal of Interventional Imaging and Therapy
2019;16(8):455-459
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the impact on treatment efficacy and safety of seromuscular-layer injury after ablation with HIFU for uterine fibroids. Methods: A total of 400 patients with uterine fibroids who underwent HIFU ablation were enrolled. All patients had completed MRI data before and after ablation. According to postoperative enhanced MR T1WI showing whether there was perfusion defect of seromuscular-layer on sagittal or axial images of whole myometrial perfusion period, the patients were divided into injured group and intact group. The patients' age, body mass index (BMI), location of uterine fibroids, type (subserous, submucous or intermural myoma), volume, distance from anterior margin of myoma to anterior abdominal wall, parameters of ablation (power and total energy), non-perfused volume (NPV) after ablation, ablation rate, energy efficiency factor (EEF), postoperative complications and pregnancy rate were compared between the two groups. Results: There were 90 cases in injured group and 310 cases in intact group. No statistical difference of patients' age, volume of uterine fibroids, distance from anterior margin of myoma to anterior abdominal wall, power of ablation nor NPV was found between the two groups (all P>0.05).There were statistical differences of location and type of uterine fibroids (both P<0.05). BMI and ablation rate of injured group were higher than those of intact group (both P<0.05), while the total energy of ablation and EEF were lower than those of intact group (both P<0.05). No complications graded as C-F of society of interventional radiology (SIR) occurred. There was no statistical difference of the incidence of SIR A and B grade complications, such as fever, sacrocaudal pain and lower abdominal pain between the two groups (all P>0.05). The postoperative pregnancy rate of the injured group and the intact group was 5.56% (5/90) and 2.26% (7/310), respectively. And there was no statistical difference (χ2=1.596, P=0.206). No adverse event related to pregnancy and deliver was observed. Conclusion: HIFU ablation for uterine fibroids may lead to uterine seromuscular-layer injury, which can be observed in patients with high BMI, subserosal fibroids at the fundus of uterus and easy to ablate fibroids (low ablation energy and EEF, high ablation rate). The postoperative pregnancy and delivery are not obviously affected by seromuscular-layer injury.
