Jayaram Ramya, Subbarayan Kalpana, Mithraprabhu Sridurga, Govindarajan Mirudhubashini
Department of Obstetrics and Gynecology, Womens Center, 146B Mettupalayam Road, Coimbatore, 641043 Tamil Nadu India.
Department of Radiology, Womens Center, 146B Mettupalayam Road, Coimbatore, 641043 Tamil Nadu India.
Fertil Res Pract. 2016 May 16;2:8. doi: 10.1186/s40738-016-0021-x. eCollection 2016.
To assess reduction in heavy menstrual bleeding and dysmenorrhea following MRI guided Focused Ultrasound Surgery (MRgFUS) of focal and diffuse adenomyosis up to 12 months post-treatment a retrospective cohort study was done at a tertiary care academic medical center for obstetrics, gynecology and infertility.
MRgFUS for adenomyosis uterus was done for thirty-seven patients presenting with symptoms of heavy menstrual bleeding and dysmenorrhea with MRI-suspected adenomyosis. The main outcome measure, was reduction in heavy menstrual bleeding, dysmenorrhea and Symptom Severity Scoring (SSS) over a 3, 6 and 12 month period. Secondary outcome was evidence of fertility preservation post procedure. D'Agostino & Pearson omnibus normality test, one-way Ananova, Pearson's correlation coefficient analysis was performed on the data. Statistical significances, p-value and r-value were determined.
Out of 37 patients who were treated by MRgFUS, 26 had sufficient follow-up to be included in the analysis. SSS calculated at 3, 6 and 12 months was significantly over the baseline. Both heavy menstrual bleeding and dysmenorrhea, which were assessed separately, were found to significantly improve over time with a positive correlation between the two. No other intervention was required.
MRgFUS provides immediate and sustained relief for patients with focal and diffuse adenomyosis.
为评估在三级医疗学术中心的妇产科及不孕症科，对局限性和弥漫性子宫腺肌病进行磁共振成像引导聚焦超声手术（MRgFUS）治疗后长达12个月的月经过多和痛经缓解情况，开展了一项回顾性队列研究。
对37例有月经过多和痛经症状且磁共振成像怀疑为子宫腺肌病的患者进行了子宫腺肌病的MRgFUS治疗。主要结局指标是在3、6和12个月期间月经过多、痛经及症状严重程度评分（SSS）的降低情况。次要结局是术后生育功能保留的证据。对数据进行了达戈斯蒂诺与皮尔逊综合正态性检验、单因素方差分析、皮尔逊相关系数分析。确定了统计学显著性、p值和r值。
在接受MRgFUS治疗的37例患者中，26例有足够的随访时间可纳入分析。在3、6和12个月时计算的SSS显著高于基线水平。单独评估的月经过多和痛经均随时间显著改善，且两者呈正相关。无需其他干预。
MRgFUS为局限性和弥漫性子宫腺肌病患者提供了即时且持续的缓解。
