Otonkoski Saara, Viitala Antti, Komar Gaber, Sainio Teija, Yanovskiy Anna, Blanco Sequieros Roberto, Perheentupa Antti, Joronen Kirsi
Department of Obstetrics and Gynaecology, Turku University Hospital, Turku, Finland.
University of Turku, Turku, Finland.
Acta Obstet Gynecol Scand. 2025 Jun;104(6):1172-1180. doi: 10.1111/aogs.15086. Epub 2025 Apr 29.
Uterine fibroids are the most common benign tumors among women, and it is estimated that approximately 70% of women have one or multiple fibroids by the age of menopause. About 30% of these women suffer from symptoms related to the fibroids. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) is a novel, non-invasive treatment method for symptomatic uterine fibroids.
In this prospective, single-centre follow-up study, 175 women with symptomatic uterine fibroids were treated with MR-HIFU. The effect of MR-HIFU on fibroid symptoms and quality of life was evaluated using a uterine fibroid-specific quality of life questionnaire (UFS-QoL). The main outcome measure was the symptom severity score and quality of life (QoL) before the MR-HIFU and 3 and 12 months after the treatment. This study was registered at clinicaltrials.gov (NCT03937401).
The median symptom severity score decreased from 56 (IQR 44-69) at baseline to 28 (IQR 16-44) at 3 months (p < 0.01) and 25 (IQR 16-38) at 12 months (p < 0.01) after treatment. The QoL score increased from a median of 48 (IQR 33-66) at baseline to 73 (IQR 59-93) at 3 months (p < 0.01) and 78 (IQR 66-90) at 12 months after treatment (p < 0.01). The reintervention rate during the 12-month follow-up was 2%.
MR-HIFU significantly reduces the severity of fibroid-related symptoms in selected patients as early as 3 months after MR-HIFU. The effect persists at 12 months. There is also a significant improvement in the quality of life 3 months after treatment, which further increases at 12 months.
子宫肌瘤是女性中最常见的良性肿瘤，据估计，约70%的女性在绝经时会有一个或多个肌瘤。这些女性中约30%患有与肌瘤相关的症状。磁共振引导高强度聚焦超声（MR-HIFU）是一种针对有症状子宫肌瘤的新型非侵入性治疗方法。
在这项前瞻性单中心随访研究中，175例有症状子宫肌瘤的女性接受了MR-HIFU治疗。使用子宫肌瘤特异性生活质量问卷（UFS-QoL）评估MR-HIFU对肌瘤症状和生活质量的影响。主要结局指标是MR-HIFU治疗前、治疗后3个月和12个月时的症状严重程度评分和生活质量（QoL）。本研究已在clinicaltrials.gov注册（NCT03937401）。
治疗后3个月，症状严重程度评分中位数从基线时的56分（四分位间距44-69）降至28分（四分位间距16-44）（p<0.01），12个月时降至25分（四分位间距16-38）（p<0.01）。生活质量评分中位数从基线时的48分（四分位间距33-66）升至治疗后3个月时的73分（四分位间距59-93）（p<0.01），12个月时升至78分（四分位间距66-90）（p<0.01）。12个月随访期间的再次干预率为2%。
MR-HIFU在选定患者中最早在治疗后3个月就能显著降低与肌瘤相关症状的严重程度。这种效果在12个月时持续存在。治疗后3个月生活质量也有显著改善，12个月时进一步提高。
