Prediction on short-term outcome of ultrasound-guided percutaneous microwave ablation therapy of uterine fibroids by magnetic resonance imaging

doi:10.3877/cma.j.issn.1672-6448.2015.07.016

Abstract

Abstract:

Objective

To study the short-term outcome of the uterine fibroids treated with ultrasound-guided percutaneous microwave ablation therapy (PMAT) by magnetic resonance imaging (MRI).

Methods

PMAT was performed in 46 symptomatic patients with a total of 49 uterine fibroids. Pre- and post-contrast MRI was scanned at 3 days before treatment and 3 days after treatment to assess image changes of both fibroids and surrounding tissues. The fibroids were divided into group A (low signal), B (iso-signal), C (high signal) by the signal intensity on T₂WI. According to the volume changes of fibroids and uterine, ablation rate and the reduction rate of the fibroids after treatment were calculated.

Results

There were 28, 17 and 4 fibroids in the group A, B and C respectively. Before the treatment the volume of the fibroids showed no statistical difference between the group A, B and C (P>0.05). Fibroids and uterine showed shrinkage after the treatment in the group A and B (t=5.644, 5.998, 6.725 and 4.678, all P<0.001). The fibroids ablation rate showed no statistical difference between the groups (F=0.852, P>0.05). Fibroids and uterine showed shrinkage after the treatment in the group C, but there was no obvious statistical difference.

Conclusions

The outcome of PAMT is good for the fibroids with different signal intensity on T2WI. But the fibroids with high signal intensity are not as sensitive as those with low or iso intensity to achieve the same ablation level.

Key words: Leiomyoma, Ultrasonography, Magnetic resonance imaging

Bo Wen, Jing Zhang, Lei Feng, Dongmei Hu, Xia Ma, Fang Wang, Yuhong Zhou. Prediction on short-term outcome of ultrasound-guided percutaneous microwave ablation therapy of uterine fibroids by magnetic resonance imaging[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(07): 574-578.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2015.07.016

https://chaosheng.cma-cmc.com.cn/EN/Y2015/V12/I07/574

Figures/Tables 6

References 16

1	Ryan GL, Syrop CH, Van Voorhis BJ. Role, epidemiology, and natural history of benign uterine mass lesions[J]. Clin Obstet Gynecol, 2005, 48(2): 312-324.
2	Miller CE. Myomectomy: comparison of open laparoscopic techniques[J]. Obstet Gynecol Clin North Am, 2000, 27(2): 407-420.
3	Dubuisson JB, Fauconnier A, Fourchotte V, et al. Laparoscopic Myomectomy: predicting the risk of conversion to open procedure[J]. Hum Rrprod, 2001, 16(8): 1727-1731.
4	Iverson RE Jr, Chelmow D, Strohbehn K et al. Relative morbidity of abdominal hysterectomy and myomectomy for management of uterine leiomyomas[J]. Obstet Gynecol, 1996, 88(3): 415-419.
5	Dicker RC, Greenspan JR, Strauss LT et al. Complications ofabdominal and vaginal hysterectomy among women of reproductive age in the United States. The Collaborative Review of Sterilization[J]. Am J Obstet Gynecol, 1982, 144(7): 841-848.
6	Wang F, Zhang J, Han ZY, et al. Imaging manifestation of conventional and contrast-enhanced ultrasonography in percutaneous microwave ablation for the treatment of uterine fibroids[J]. Eur J Radiol, 2012, 81(11): 2947-2952.
7	Zhang J, Feng L, Zhang B, et al. Ultrasound-guided percutaneous microwave ablation for symptomatic uterine fibroid treatment--a clinical study[J]. Int J Hyperthermia, 2011, 27(5): 510-516.
8	张晶，冯蕾，张冰松, 等. 超声引导经皮子宫肌瘤微波消融后随访研究[J]. 中华医学杂志, 2011, 91(1): 48-50.
9	Zhang J, Feng L, Zhang B, et al. Initial clinical study of ultrasound-guided percutaneous microwave ablation of adenomyosis[J]. Ultrasound in Obstetrics & Gynecology, 2010, 36 (Suppl 1): 73.
10	张晶，冯蕾，张冰松, 等. 经皮微波凝固子宫肌瘤效果研究[J/CD]. 中华医学超声杂志:电子版, 2010: 8(1): 39-42.
11	Rowland IJ, Ribens I, Chen L, et al. MRI study of hepatic tumours following high intensity foused ultrasound surgery[J]. Br J Radiol, 1997, 70(2): 144-153.
12	Swe TT, Onitsuka H, Kawamoto K, et al. Uterine leiomyoma: correlation between signal intensity on magnetic resonance imaging and pathologic characteristics[J]. Radiat Med, 1992, 10(6): 235-242.
13	Schwartz LB, Zawin M, Carcangiu ML, et al. Does pelvic magnetic resonance imaging differentiate among the histologic subtypes of uterine leiomyomata?[J]. Fertil Steril, 1998, 70(3): 580-587.
14	张嵘，梁碧玲，付加平, 等. 子宫肌瘤的MRI表现与临床病理相关性研究. 中华放射学杂志, 2003, 37(10): 954-959.
15	Boaz TL, Lewin JS, Chung YC, et al. MR monitoring of MR-guided radiofrequency thermal ablation of normal liver in an animal model[J]. J Magn Reson Imaging, 1998, 8(1): 64-69.
16	Mueller-Lisse UG, Thoma M, Faber S, et al. Coagulative interstitial laser-induced thermotherapy of benign p rostatic hyperp lasia: online imagingwith a T2-weighted fast spin-echo MR sequence-experience in six patients[J]. Radiology, 1999, 210(2): 373-379.

组别	个数	子宫体	肌瘤
消融前	49	351.6±213.6	106.5±64.8
消融后	49	276.3±205.5	88.9±58.0
t值	?	8.449	7.455
P值	?	<0.001	<0.001

组别	个数	子宫体	肌瘤
消融前	49	351.6±213.6	106.5±64.8
消融后	49	276.3±205.5	88.9±58.0
t值	?	8.449	7.455
P值	?	<0.001	<0.001

组别	个数	消融前	消融后	t值	P值
A组	28	257.5±99.7	198.63±87.0	6.725	<0.001
B组	17	460.8±269.2	366.5±276.6	4.678	<0.001
C组	4	229.3±173.3	196.3±151.9	2.58	>0.05

组别	个数	消融前	消融后	t值	P值
A组	28	257.5±99.7	198.63±87.0	6.725	<0.001
B组	17	460.8±269.2	366.5±276.6	4.678	<0.001
C组	4	229.3±173.3	196.3±151.9	2.58	>0.05

组别	个数	消融前	消融后	t值	P值
A组	28	96.0±46.9	77.0±36.8	5.644	<0.001
B组	17	94.8±65.3	77.8±57.9	5.998	<0.001
C组	4	102.5±89.9	93.2±86.2	2.113	>0.05

Please choose a citation manager

Content to export