6例子宫肌瘤高强度聚焦超声治疗失败原因浅析

The Analysis of the Reasons of the Failure of the Treatment of Six Patients of Uterus Muscular Tumors With High Intensity Focused Ultrasound

目的分析高强度聚聚焦超声(HIFU)体外治疗子宫肌瘤失败的原因和解决的办法。方法选择不麻醉下体外HI-FU治疗子宫肌瘤效果不佳改为妇科手术切除的患者,分析HIFU治疗过程中B超复查的声图像资料。结果6例子宫肌瘤患者分别采用HIFU治疗最少3次,最多9次。每次HIFU治疗后B超复查子宫肌瘤未见有肯定的明显回声改变。彩色多普勒血流显像,肌瘤周边或肌瘤内的血流信号无明显减少。肌瘤体积无缩小,反而逐渐增大。6例子宫肌瘤患者,有5例做了切除手术,1例在B超引导下,穿刺注射硬化剂后再做HIFU治疗,肌瘤体积迅速缩小,目前仍在观察中。结论HIFU治疗子宫肌瘤失败,主要是HIFU治疗靶区焦点的声强不够。联合超声介入治疗可以增加HIFU治疗靶区的超声能量,提高HIFU治疗肌瘤的效果。

Objective Analysis of the reasons and solutions of the failure of the treatment of myoma of uterus with High Intensity Focused Ultrasound （HIFU）. Methods Analysis changes of photos of ultrasound-B of the patients who had to be operated of incision because of the failure of the treatment of HIFU. Results Six patients were treated with HIFU 3 times to 9 times. No much changes of ultrasound in the tumor after the treatment of HIFU, and the same situation with the color Doppler （no changes of blood stream in or around the tumor）. Volumes of the tumors did not become smaller but larger Five of six patients were under incision and one patient was observing now because the tumor was reduced obviously after the treatment of HIFU with injection of hardener to the tumor under the guide of ultrasound-B. Conclusions The reason for failure of the treatment of myoma of uterus with HIFU is that intensity of the ultrasound was not strong enough in focus of the tumor. It will increase the energy of ultrasound in the focus of the tumor and improves the curative effect of the treatment of myoma of uterus with HIFU, combined with the treatment of intervention of ultrasound.