Cheung Vincent Y T, Lam Tina P W, Jenkins Caroline R, Lam S W, Cheung Grace K I, Chan Selina S Y, Choi W K
a Department of Obstetrics and Gynaecology , Queen Mary Hospital, The University of Hong Kong , Hong Kong , ROC.
b Department of Diagnostic Radiology , Queen Mary Hospital, The University of Hong Kong , Hong Kong , ROC.
J Obstet Gynaecol. 2019 Aug;39(6):833-839. doi: 10.1080/01443615.2019.1581740. Epub 2019 Apr 22.
The objective of this prospective cohort study was to evaluate the therapeutic efficacy and safety of ultrasound-guided high-intensity focussed ultrasound (HIFU) in the treatment of uterine fibroids. Twenty premenopausal women with symptomatic fibroids underwent ultrasound-guided HIFU therapy. Twenty-two fibroids with a median baseline volume of 127.0 cm (range 18.5-481.2 cm) were treated. The percentages fibroid volume reduction were 46.9 (range -8.8-73.1) at 1-month, 57.4 (-51.5-95.2) at 3-month, 60.1 (-18.9-97.8) at 6-month and 75.9 (-33.7-99.3) at 12-month, after treatment. The modified Uterine Fibroid Symptom and Quality of Life (UFS-QOL) scores were reduced by 40.7% (0-59.3%) at 3-month, 45.5% (0-70.4%) at 6-month and 44.9% (0-71.4%) at 12-month after treatment. Three patients required subsequent surgical interventions. No significant complications were encountered. Ultrasound-guided HIFU appears to be effective and safe for the treatment of symptomatic uterine fibroids in selected patients. Impact statement Ultrasound-guided high-intensity focussed ultrasound (HIFU) is a relatively new uterine-sparing treatment for fibroids. Most clinical reports are from China, which suggest that this treatment is a safe and effective modality. However, in many other countries, HIFU treatment for fibroids, especially using ultrasound as image guidance, is still considered novel with limited clinical experience. This preliminary report adds to our limited local experience on HIFU and provides reassurance on our continual utilisation of this treatment modality for fibroids. With the increasing demand of uterine-sparing alternatives, experiences shared among different countries are important to make this treatment modality generalisable and universally acceptable. Ultrasound-guided HIFU (USgHIFU) can potential be offered as an alternative treatment modality for women with fibroids.
这项前瞻性队列研究的目的是评估超声引导下高强度聚焦超声（HIFU）治疗子宫肌瘤的疗效和安全性。20名有症状子宫肌瘤的绝经前女性接受了超声引导下的HIFU治疗。共治疗了22个肌瘤，基线体积中位数为127.0立方厘米（范围18.5 - 481.2立方厘米）。治疗后，1个月时肌瘤体积缩小百分比为46.9%（范围-8.8% - 73.1%），3个月时为57.4%（-51.5% - 95.2%），6个月时为60.1%（-18.9% - 97.8%），12个月时为75.9%（-33.7% - 99.3%）。改良的子宫肌瘤症状与生活质量（UFS-QOL）评分在治疗后3个月降低了40.7%（0 - 59.3%），6个月时降低了45.5%（0 - 70.4%），12个月时降低了44.9%（0 - 71.4%）。3名患者需要后续手术干预。未出现重大并发症。超声引导下的HIFU似乎对选定患者的有症状子宫肌瘤治疗有效且安全。影响声明 超声引导下高强度聚焦超声（HIFU）是一种相对较新的保留子宫的子宫肌瘤治疗方法。大多数临床报告来自中国，表明这种治疗是一种安全有效的方式。然而，在许多其他国家，HIFU治疗子宫肌瘤，尤其是使用超声作为图像引导，仍被认为是新颖的，临床经验有限。 这份初步报告增加了我们当地关于HIFU的有限经验，并为我们继续将这种治疗方式用于子宫肌瘤提供了信心。随着对保留子宫替代方案需求的增加，不同国家之间分享经验对于使这种治疗方式具有普遍性和广泛可接受性很重要。超声引导下的HIFU（USgHIFU）有可能作为子宫肌瘤女性的替代治疗方式提供。
