Recaldini Chiara, Carrafiello Gianpaolo, Laganà Domenico, Cuffari Salvatore, Bergamini Valentino, Ghezzi Fabio, Fugazzola Carlo
Department of Radiology, University of Insubria, Viale Borri 57, 21100 Varese, Italy.
AJR Am J Roentgenol. 2007 Dec;189(6):1303-6. doi: 10.2214/AJR.07.2184.
The purpose of this study was to assess the feasibility and safety of percutaneous radiofrequency ablation under sonographic guidance as a unique procedure in the management of symptomatic uterine myomas.
Six premenopausal women with symptomatic submucosal or intramural uterine myomas underwent percutaneous radiofrequency ablation under suprapubic sonographic guidance. Relief of symptoms and reduction in the diameter and volume of the myomas were measured every 3 months.
The location of myomas was anterior and submucosal in one of the six patients and intramural in the other five (one posterior, one anterior, two fundal, and one on the left side). Five of the patients had pelvic pain, and four had menorrhagia. The median baseline diameter was 4.8 cm (range, 4.4-5.2 cm), and the mean volume was 58.57 cm3 (range, 44.58-73.58 cm3). The mean follow-up time was 9 months (range, 3-12 months). At follow-up, the median diameter was 2.3 cm (range, 1.20-3.2 cm), and the median volume was 8.97 cm3 (range, 0.90-18.81 cm3). The median preoperative symptom score was 47.2 (31.8-67.30), and the median health-related quality of life (QOL) score was 63.92 (37.20-86.00). The median symptom score during follow-up was 5.15 (range, 0-26), and the mean QOL score was 96.2 (range, 86.30-100). Four of six patients were symptom-free at the last follow-up visit.
Percutaneous sonographically guided radiofrequency ablation alone is a feasible and efficient procedure in the management of medium-sized uterine myomas.
本研究旨在评估超声引导下经皮射频消融术作为治疗有症状子宫肌瘤的一种独特方法的可行性和安全性。
6名有症状的黏膜下或肌壁间子宫肌瘤的绝经前女性在耻骨上超声引导下接受了经皮射频消融术。每3个月测量症状缓解情况以及肌瘤直径和体积的减小情况。
6例患者中，1例肌瘤位于前位且为黏膜下，另外5例为肌壁间肌瘤（1例在后位，1例在前位，2例在宫底部，1例在左侧）。5例患者有盆腔疼痛，4例有月经过多。基线直径中位数为4.8 cm（范围4.4 - 5.2 cm），平均体积为58.57 cm³（范围44.58 - 73.58 cm³）。平均随访时间为9个月（范围3 - 12个月）。随访时，直径中位数为2.3 cm（范围1.20 - 3.2 cm），体积中位数为8.97 cm³（范围0.90 - 18.81 cm³）。术前症状评分中位数为47.2（31.8 - 67.30），健康相关生活质量（QOL）评分中位数为63.92（37.20 - 86.00）。随访期间症状评分中位数为5.15（范围0 - 26），QOL评分平均值为96.2（范围86.30 - 100）。6例患者中有4例在最后一次随访时无症状。
单纯超声引导下经皮射频消融术是治疗中等大小子宫肌瘤的一种可行且有效的方法。
