MR-HIFU治疗子宫肌瘤58例疗效观察

The clinical effect analysis of MR-HIFU in the treatment of uterine fibroids

目的探讨磁共振成像导向下高强度聚焦超声(MR-HIFU)治疗子宫肌瘤的疗效及安全性。方法回顾性分析2012年1月至2016年8月于我院就诊的符合入组标准的58例子宫肌瘤患者的临床资料,观察治疗前后肌瘤体积、肌瘤非灌注体积(NPV)的变化,以及治疗过程中患者的不良反应发生情况。结果治疗1、3和6个月后,患者的肌瘤体积平均缩小20.1%、39.6%和48.8%。治疗6个月 NPV百分比的平均值为(53.5±21.3)%。治疗6个月后,月经量多的患者中有60.7%(17/28)症状较前有所改善,下腹疼痛不适的患者中有53.3%(7/15)症状明显改善,轻微尿频的患者中有25.0%(1/4)症状缓解,表现为月经频发的患者症状未见明显改变。没有发现近期及远期严重不良反应。结论 MR-HIFU治疗能有效缩小子宫肌瘤体积,无严重的术后并发症发生,可能是一种治疗子宫肌瘤安全有效的新技术。

Objective To explore the efficacy and safety of magnetic resonance imaging-guided high intensity focused ultrasound (MR-HIFU) in the treatment of uterine fibroids. Methods From January 2012 to August 2016, 58 patients with uterine fibroids who were admitted to the First Affiliated Hospital of Xi’an Jiaotong University were analyzed retrospectively. The reduction of fibroid volume after treatment, the measurement of non-perfusion volume (NPV) by magnetic resonance imaging, and the occurrence of adverse reactions in patients during the treatment of MR-HIFU were observed. Results After 1 month, 3 months and 6 months of treatment, fibroid volume decreased by 20.1%, 39.6% and 48.8%, respectively. The mean value of NPV at 6 months of treatment was (53.5±21.3)%. After 6 months of treatment, 60.7% of the patients with menorrhagia showed improved symptoms (17/28), 53.3% of the patients with pain and discomfort in the lower abdomen showed significant improvement (7/15), and 25.0%(1/4) of the patients with frequency of urination showed improved symptoms. There was no significant change in symptoms in patients with polymenorrhea. No serious adverse reactions were found. Conclusions MR-HIFU can significantly reduce the volume of fibroids in patients, without serious postoperative complications, so it may become a safe and effective treatment for uterine fibroids.