Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
Int J Hyperthermia. 2021;38(1):1601-1608. doi: 10.1080/02656736.2021.1993357.
To investigate the combined enhancing effects of microbubble-contrast SonoVue and oxytocin on high-intensity focused ultrasound (HIFU) ablation of adenomyosis.
330 patients with adenomyosis were randomly assigned to SonoVue and oxytocin group (group A, = 82), oxytocin (group B, = 85), SonoVue (group C, = 81), or the control (group D, = 82) for HIFU ablation. In group A, oxytocin was dripped 0.32 IU/min, and HIFU ablation was started one minute after SonoVue injection. In group B, oxytocin was dripped 0.32 IU/min during ablation. In group C, HIFU ablation was started one minute after SonoVue injection. In group D, neither oxytocin nor SonoVue was applied. The clinical data, treatment results, and complications were analyzed.
All participants underwent HIFU treatment safely, and the mean energy efficiency factor (EEF) in the four groups was 4.7 ± 0.9J/mm, 8.5 ± 0.6J/mm, 8.9 ± 0.7J/mm, and 12.6 ± 1.8J/mm, respectively, with the mean ablation time (AT) of 633.7 ± 55.1 s, 874.2 ± 65.6 s, 936.3 ± 85.2 s, and 1103.2 ± 96.2 s, respectively. The non-perfused volume ratios (NPVR) were 90.4 ± 8.8%, 88.7 ± 9.1%, 89.4 ± 7.2%, 80.5 ± 7.9%, respectively. In addition, EEF and AT were the shortest in group A ( < 0.05). NPVR was significantly higher in group A than in the control group D ( < 0.05). The incidence rates of adverse events were not significantly different in the four groups ( > 0.05).
Compared to the control group, oxytocin combined with SonoVue in HIFU for adenomyosis can significantly decrease the energy and time needed for the ablation and safely enhance the treatment efficiency by improving the cavitation and heating of HIFU ablation and increasing the non-perfused volume ratio.
研究微泡造影剂 SonoVue 和缩宫素联合增强高强度聚焦超声(HIFU)消融治疗子宫腺肌病的效果。
将 330 例子宫腺肌病患者随机分为 SonoVue 和缩宫素组(A 组,n=82)、缩宫素组(B 组,n=85)、SonoVue 组(C 组,n=81)和对照组(D 组,n=82),行 HIFU 消融治疗。A 组于 SonoVue 注射后 1 分钟开始滴注缩宫素 0.32IU/min,行 HIFU 消融治疗;B 组于 HIFU 消融过程中持续滴注缩宫素 0.32IU/min;C 组于 SonoVue 注射后 1 分钟开始行 HIFU 消融治疗;D 组不应用缩宫素或 SonoVue。分析各组临床资料、治疗效果及并发症。
所有患者均安全完成 HIFU 治疗,四组的平均能量效率因子(EEF)分别为 4.7±0.9J/mm、8.5±0.6J/mm、8.9±0.7J/mm 和 12.6±1.8J/mm,平均消融时间(AT)分别为 633.7±55.1s、874.2±65.6s、936.3±85.2s 和 1103.2±96.2s,非灌注体积比(NPVR)分别为 90.4±8.8%、88.7±9.1%、89.4±7.2%和 80.5±7.9%。A 组的 EEF 和 AT 最短(均 P<0.05),NPVR 明显高于对照组 D(均 P<0.05)。四组不良反应发生率差异无统计学意义(均 P>0.05)。
与对照组相比,HIFU 联合 SonoVue 和缩宫素治疗子宫腺肌病可显著减少消融所需的能量和时间,通过提高 HIFU 消融的空化和加热效果,增加非灌注体积比,安全有效地提高治疗效率。