State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
Int J Hyperthermia. 2022;39(1):530-538. doi: 10.1080/02656736.2022.2052366.
To evaluate the mid-term symptom improvement of patients with different types of adenomyosis based on magnetic resonance imaging (MRI) classification after ultrasound-guided high intensity focused ultrasound (USgHIFU) treatment.
A total of 321 patients with adenomyosis who underwent HIFU and completed 18-month follow-up were retrospectively reviewed. Based on the relationship between the adenomyotic lesion and the uterine structural components on T2-weighted imaging (T2WI), adenomyotic lesions were classified as internal, external, full thickness and intramural adenomyosis. Based on the extent of the myometrial involvement, these lesions were further subclassified as asymmetric and symmetric adenomyosis.
All patients completed HIFU ablation in one session. The range of median menstrual pain score in patients with asymmetric internal, symmetric internal, asymmetric external, asymmetric full thickness, symmetric full thickness, and intramural adenomyosis was between 6 and 8 points before HIFU, the median menstrual pain score decreased to 2-4 points 18-month post-HIFU ( < .005). The menstrual pain relief rate was 68.3%, 62.1%, 54.7%, 64.1%, 60%, and 100%, respectively. The median menstrual blood volume score range was between 2 and 4 points in the different groups of patients before HIFU, it decreased to 1-3 points 18-month after HIFU with a relief rate of 68.3%, 51.6%, 51.0%, 55.5%, 57.2%, and 100%, respectively. No serious complication occurred in any of these patients.
Based on our results, USgHIFU is safe and effective in the treatment of patients with different subtypes of adenomyosis with mid-term sustained improvement in symptoms of menstrual pain and menstrual blood volume.
基于磁共振成像（MRI）分类，评估超声引导高强度聚焦超声（USgHIFU）治疗后不同类型子宫腺肌病患者的中期症状改善情况。
回顾性分析了 321 例接受 HIFU 治疗并完成 18 个月随访的子宫腺肌病患者。根据 T2 加权成像（T2WI）上腺肌瘤与子宫结构成分的关系，将腺肌瘤分为内部型、外部型、全层型和壁内型。根据子宫肌层受累的范围，将这些病变进一步分为不对称型和对称型腺肌病。
所有患者均在一次治疗中完成了 HIFU 消融。不对称型内部、对称型内部、不对称型外部、不对称型全层、对称型全层和壁内型腺肌病患者在 HIFU 治疗前的中位经期疼痛评分范围为 6-8 分，HIFU 治疗后 18 个月时降至 2-4 分（ < .005）。痛经缓解率分别为 68.3%、62.1%、54.7%、64.1%、60%和 100%。不同组患者在 HIFU 治疗前的中位经期血量评分范围为 2-4 分，HIFU 治疗后 18 个月时降至 1-3 分，缓解率分别为 68.3%、51.6%、51.0%、55.5%、57.2%和 100%。所有患者均未发生严重并发症。
基于我们的研究结果，USgHIFU 治疗不同亚型子宫腺肌病安全有效，可使患者的经期疼痛和经期血量症状在中期持续改善。
