Department of Gynecology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Department of Gynecology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
Int J Hyperthermia. 2024;41(1):2384459. doi: 10.1080/02656736.2024.2384459. Epub 2024 Jul 29.
This study aimed to explore the efficacy and safety of high-intensity focused ultrasound (HIFU) ablation for treating fumarate hydratase (FH)-deficient uterine leiomyomas.
Ten patients with FH-deficient uterine leiomyomas treated with HIFU ablation at the Third Xiangya Hospital from July 2017 to January 2023 were enrolled in this study. The effectiveness and adverse effects of HIFU were analyzed.
The median age of the patients who received HIFU was 32.0 years (range: 28-41 years). Only 2 patients had solitary uterine leiomyomas, whereas the remaining 8 patients had multiple uterine leiomyomas. The median diameter of the largest myoma was 56 mm (range: 41-99 mm). Magnetic resonance imaging showed that the FH-deficient uterine leiomyomas of 8 patients presented as mixed intensity on T2WI, that of one patient was hypointense, and that of another patient was hyperintense on T2WI. All patients successfully underwent HIFU ablation in one session without severe adverse effects. The median nonperfusion volume ratio (NPVR) was 40% (30.0%-78.0%) after HIFU treatment. Four patients had NPVR ≥70%. At 3-month follow-up after HIFU ablation, the clinical symptoms of 5 of the 8 patients with symptoms before treatment were relieved. Six months after treatment, 4 of the 8 patients with symptoms were still in remission. All patients received reintervention by March 2024. The reintervention rates were 20%, 70%, and 90% at 12, 24, and 36 months, respectively, after HIFU ablation.
HIFU is a safe and feasible treatment for FH-deficient uterine leiomyomas, and most patients show effective results in the short term after treatment. However, the reintervention rates are high, and the long-term effects are limited.
本研究旨在探讨高强度聚焦超声（HIFU）消融治疗琥珀酸氢酶（FH）缺陷型子宫平滑肌瘤的疗效和安全性。
回顾性分析 2017 年 7 月至 2023 年 1 月在我院接受 HIFU 消融治疗的 10 例 FH 缺陷型子宫平滑肌瘤患者的临床资料，分析 HIFU 的有效性和不良反应。
10 例患者的中位年龄为 32.0 岁（范围：28-41 岁）。仅 2 例患者为单发子宫肌瘤，余 8 例患者为多发子宫肌瘤。最大肌瘤直径为 56.0mm（范围：41-99.0mm）。磁共振成像（MRI）显示，8 例 FH 缺陷型子宫平滑肌瘤在 T2WI 上呈混杂信号，1 例呈低信号，1 例呈高信号。所有患者均 1 次性成功完成 HIFU 消融治疗，无严重不良反应。HIFU 治疗后非增强体积比（NPVR）中位数为 40%（30.0%-78.0%）。4 例患者 NPVR≥70%。HIFU 消融治疗后 3 个月随访时，8 例有症状患者中 5 例症状缓解。治疗 6 个月后，8 例有症状患者中 4 例仍处于缓解状态。所有患者均于 2024 年 3 月前接受再次介入治疗。HIFU 消融后 12、24 和 36 个月的再次介入率分别为 20%、70%和 90%。
HIFU 治疗 FH 缺陷型子宫平滑肌瘤安全可行，大多数患者在治疗后短期内效果明显，但再干预率较高，长期效果有限。
