Fruehauf Johannes H, Back Walter, Eiermann Alexa, Lang Michael-Christian, Pessel Martin, Marlinghaus Ernst, Melchert Frank, Volz-Köster Stefanie, Volz Joachim
Department of Obstetrics and Gynaecology, University Hospital Mannheim, Mannheim, Germany.
Arch Gynecol Obstet. 2008 Feb;277(2):143-50. doi: 10.1007/s00404-007-0435-0. Epub 2007 Sep 7.
High intensity focused ultrasound (HIFU) is a novel method which offers the non-invasive ablation of tissues without harming overlying organs or skin. It has been introduced successfully in urology for the ablation of prostatic hyperplasia and seems to be promising in the treatment of uterine fibroids. In this study we aimed to examine the feasibility and possible side effects of HIFU treatment of uterine tissues using an experimental mobile HIFU unit with ultrasound guidance.
For these experiments, a 1.07 MHz ultrasound source was used which allows treatment depths between 0 and 10 cm. In 12 patients scheduled to have abdominal hysterectomy, 5-60 impulses of HIFU were applied through the intact skin upon uterine tissues directly prior to the surgical procedure. Tissue intensities lay between 3,200 and 6,300 W/cm(2) and a fixed pulse length of 4 s was used.
No side effects were encountered other than one first-degree skin burn and the treatment was well tolerated. Histology showed clearly demarcated coagulative necrosis in the targeted tissues. Treatment was concluded in less than 45 min for each patient.
Focused ultrasound is an effective method to selectively destroy tissue within the uterus and the transabdominal access route is very feasible. This study shows that a mobile ultrasound source can be used safely and effectively to destroy uterine tissues, such as fibroids, without major side effects.
高强度聚焦超声（HIFU）是一种新型方法，可在不损伤覆盖器官或皮肤的情况下对组织进行非侵入性消融。它已成功引入泌尿外科用于前列腺增生的消融，并且在子宫肌瘤的治疗中似乎很有前景。在本研究中，我们旨在使用带有超声引导的实验性移动HIFU设备来检验HIFU治疗子宫组织的可行性及可能的副作用。
对于这些实验，使用了一个1.07兆赫兹的超声源，其治疗深度在0至10厘米之间。在12例计划进行腹式子宫切除术的患者中，在手术前通过完整皮肤对子宫组织直接施加5 - 60次HIFU脉冲。组织强度在3200至6300瓦/平方厘米之间，并使用固定的4秒脉冲长度。
除了1例一度皮肤烧伤外，未遇到其他副作用，且治疗耐受性良好。组织学显示靶组织中有清晰界定的凝固性坏死。每位患者的治疗在不到45分钟内完成。
聚焦超声是一种有效选择性破坏子宫内组织的方法，经腹途径非常可行。本研究表明，移动超声源可安全有效地用于破坏子宫组织，如子宫肌瘤，且无重大副作用。
