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新加坡子宫肌瘤的磁共振引导聚焦超声手术(MRgFUS)。

Magnetic resonance-guided focused ultrasound surgery (MRgFUS) of uterine fibroids in Singapore.

作者信息

Han Nian-Lin R, Ong Chiou Li

机构信息

Division of Clinical Support Services, KK Women's and Children's Hospital, Singapore.

出版信息

Ann Acad Med Singap. 2014 Nov;43(11):550-8.

Abstract

INTRODUCTION

Uterine fibroids are the most common type of gynaecologic benign tumours, occurring in 25% to 50% of women during their reproductive lives. About half of the affected women have clinically significant symptoms, including abnormal bleeding, menstrual pain, frequent urination, constipation and abdominal distension. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) has been used to treat patients with benign lesions and a variety of malignancies. The objective of this study is to evaluate symptom relief before and after MR-guided ultrasound ablation of fibroids.

MATERIALS AND METHODS

A total of 37 patients with symptomatic uterine fibroids were treated in this study.

RESULTS

MRgFUS treatment led to a significant, time-dependent decrease in not only Symptom Severity Scores (SSS), but also the mean fibroid volume. The average reductions in volume were 41.6% and 52.6% at 6 months and 12 months respectively (P <0.05). The mean SSS of the 37 patients was 41.7 ± 2.8 before treatment whereas the average SSS was 26.9 ± 3.6, 20.7 ± 3.4, 18.5 ± 3.6, 16.5 ± 7.1, 9.8 ± 3.6 at 3 months, 6 months, 1 year, 2 years, and 3 to 4 years respectively. The decrease in scores was significant at all time points up to 3 to 4 years (P <0.05 and P <0.001).

CONCLUSION

MRgFUS is a safe and effective non-invasive treatment for patients with symptomatic fibroids.

摘要

引言

子宫肌瘤是最常见的妇科良性肿瘤,25%至50%的女性在其生育期会出现。约一半受影响的女性有临床显著症状,包括异常出血、痛经、尿频、便秘和腹胀。磁共振引导聚焦超声手术(MRgFUS)已用于治疗良性病变和多种恶性肿瘤患者。本研究的目的是评估磁共振引导超声消融子宫肌瘤前后的症状缓解情况。

材料与方法

本研究共治疗了37例有症状的子宫肌瘤患者。

结果

MRgFUS治疗不仅导致症状严重程度评分(SSS)显著且随时间下降,肌瘤平均体积也显著下降。6个月和12个月时体积平均减少分别为41.6%和52.6%(P<0.05)。37例患者治疗前平均SSS为41.7±2.8,而在3个月、6个月、1年、2年以及3至4年时平均SSS分别为26.9±3.6、20.7±3.4、18.5±3.6、16.5±7.1、9.8±3.6。直至3至4年,各时间点评分下降均显著(P<0.05和P<0.001)。

结论

MRgFUS是一种治疗有症状子宫肌瘤患者的安全有效的非侵入性疗法。

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