Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, 17 W Changle Road, Xi'an, Shaanxi 710032, China.
Cardiovasc Intervent Radiol. 2010 Aug;33(4):794-9. doi: 10.1007/s00270-010-9909-8. Epub 2010 Jun 11.
This study compared the technical success of fibroid devascularization using high-intensity focused ultrasound (HIFU) and radio frequency (RF) to provide an experimental basis for the clinical selection of a suitable, minimally invasive method for treating uterine fibroids. Patients were randomly divided into two groups and treated with HIFU or RF accordingly. The two groups of patients were divided again into subgroups A, B, and C based on fibroid diameter and subgroups A', B', and C' based on fibroid blood supply grades. The fibroid diameters in subgroups A, B, and C were 2.0 cm <or= D < 4.0 cm, 4.0 cm <or= D<6.0 cm and 6.0 cm <or= D<8.0 cm, respectively, and fibroid blood supplies were classified into three grades corresponding to subgroups A', B', and C', respectively. The complete ablation rates of the two treatments were compared by contrast-enhanced ultrasound. Both treatments were effective, but the general complete ablation rate of RF was higher than that of HIFU (p < 0.05). The comparison between the two treatments in subgroup A and subgroup A' showed that the complete ablation rate of HIFU was as good as that of RF (p > 0.05). In other subgroups, the complete ablation rates of RF were better than those of HIFU (p < 0.05). No severe complications were observed after these two treatments. RF can be applied for the majority of fibroids. As a noninvasive therapy, HIFU could be the preferred method for the treatment of small, hypovascular fibroids.
本研究比较了高强度聚焦超声（HIFU）和射频（RF）消融子宫肌瘤的技术成功率，为临床选择合适的微创方法治疗子宫肌瘤提供了实验依据。患者随机分为两组，分别接受 HIFU 或 RF 治疗。根据肌瘤直径，将两组患者再次分为 A、B、C 亚组，根据肌瘤血供分级，将 A、B、C 亚组分为 A'、B'和 C'亚组。A、B 和 C 亚组的肌瘤直径分别为 2.0cm≤D<4.0cm、4.0cm≤D<6.0cm 和 6.0cm≤D<8.0cm，相应的肌瘤血供分为 A'、B'和 C'亚组。通过增强超声比较两种治疗方法的完全消融率。两种治疗方法均有效，但 RF 的总体完全消融率高于 HIFU（p<0.05）。在 A 亚组和 A'亚组中比较两种治疗方法，HIFU 的完全消融率与 RF 相当（p>0.05）。在其他亚组中，RF 的完全消融率优于 HIFU（p<0.05）。两种治疗后均未观察到严重并发症。RF 可适用于大多数肌瘤。作为一种非侵入性治疗方法，HIFU 可能是治疗小、低血流肌瘤的首选方法。
