Sakuhara Yusuke, Shimizu Tadashi, Kodama Yoshihisa, Sawada Akihiro, Endo Hideho, Abo Daisuke, Hasegawa Tenshu, Miyasaka Kazuo
Department of Radiology, Hokkaido University School of Medicine, N-15, Sapporo, Hokkaido 060-8638, Japan.
Cardiovasc Intervent Radiol. 2006 Jul-Aug;29(4):552-8. doi: 10.1007/s00270-004-6163-y.
Uterine fibroids (leiomyomas) are the most common tumors of the uterus. The present study evaluated the feasibility and effectiveness of magnetic resonance (MR)-guided percutaneous cryoablation for uterine fibroids as a minimally invasive treatment alternative.
From August 2001 to June 2002, MR-guided percutaneous cryoablation was performed on seven uterine fibroids in 6 patients who displayed clinical symptoms related to tumors. Using a horizontal-type open MR system, cryoablation probes were percutaneously placed in fibroids. Fibroids were ablated, and the site and size of ice balls were monitored on MR imaging. Postoperatively, patients completed a questionnaire to assess changes in presenting clinical symptoms, and MR images were obtained for all patients at follow-up. Changes in clinical symptoms and tumor volume were evaluated in each patient.
All treated patients showed reductions in tumor size. Mean volume reduction rate was 40.3% at 6 weeks postoperatively, and 79.4% at 9-12 months. All patients reported fever after treatment. Surgical drainage was required for abscess in the probe channel in one patient, and transient liver damage occurred in another. Subjective symptoms improved in all patients except one who had multiple tumors, and no patient complained of new symptoms after cryoablation during follow-up.
MR-guided percutaneous cryoablation represents a feasible and effective treatment for uterine fibroids.
子宫肌瘤是子宫最常见的肿瘤。本研究评估了磁共振(MR)引导下经皮冷冻消融术作为一种微创治疗选择用于子宫肌瘤的可行性和有效性。
2001年8月至2002年6月,对6例出现与肿瘤相关临床症状的患者的7个子宫肌瘤进行了MR引导下经皮冷冻消融术。使用卧式开放式MR系统,将冷冻消融探针经皮置入肌瘤内。对肌瘤进行消融,并在MR成像上监测冰球的部位和大小。术后,患者完成一份问卷以评估所呈现临床症状的变化,并在随访时为所有患者获取MR图像。评估每位患者临床症状和肿瘤体积的变化。
所有接受治疗的患者肿瘤大小均减小。术后6周平均体积缩小率为40.3%,9至12个月时为79.4%。所有患者治疗后均出现发热。1例患者的探针通道出现脓肿,需要手术引流,另1例出现短暂性肝损伤。除1例有多发性肿瘤的患者外,所有患者的主观症状均有改善,且在随访期间没有患者在冷冻消融术后抱怨出现新症状。
MR引导下经皮冷冻消融术是一种治疗子宫肌瘤可行且有效的方法。