Ultrasound-guided focused ultrasound ablation of intramural, submucosal and subserosal uterine fibroids:12-month follow-up results

REN Dehong; WANG Wei; WANG Yang; YAO Yuanqing; TANG Jie

doi:10.3969/j.issn.1673-4254.2014.07.13

Abstract：Objective To evaluate the effect of ultrasound-guided focused ultrasound ablation (US-FUA) in the treatment of intramural, submucosal and subserosal uterine fibroids. Methods We prospectively assessed the efficacy of US-FUA for treatment of symptomatic uterine fibroids by determining the volume ablation ratio immediately after the treatment and evaluating the volume changes of the uterine fibroids on contrast-enhanced MRI at 6 and 12 months after the treatment. The symptom severity score (SSS) was examined before and at 6 and 12 months after the treatment. Results A total of 110 women with 145 symptomatic fibroids undergoing US-FUA between August 2011 and December 2012 were enrolled. The fibroids were located intramurally in 72 (49.7%), submucosally in 49 (33.8%) and subserosally in 24 (16.6%) patients, who had comparable mean volume ablation ratios [(93.2 ± 13.1)% vs (94.9 ± 9.3)% vs (89.6 ± 19.3)%, P>0.05]. The volume of the treated fibroids was reduced by (47.3 ± 20.8)%, (70.3 ± 22.2)%and (47.8 ± 13.6)%at 6 months after US-FUA and by (58.9 ± 19.9)%, (82.0 ± 21.2)%, and (50.5±17.8)%at 12 months, respectively, demonstrating a more obvious volume reduction for submucosal fibroids (P<0.05). The SSS scores of the 3 groups before treatment were 29.1±15.2, 34.8±14.5 and 26.6±23.4, respectively, which decreased significantly to 18.4 ± 15.8, 15.5 ± 10.7, and 11.6 ± 11.7 at 6 months (P<0.05) and to 18.9 ± 13.2, 16.8 ± 14.0, 11.5 ± 9.1 at 12 months (P<0.05). No major complications occurred in these patients during the 12-month follow-up. Conclusions US-FUA can yield high ablation ratios for intramural, submucosal and subserosal fibroids and result in significant volume reduction and symptomatic improvement at 6 and 12 months after the treatment, suggesting its value as a new noninvasive option for fibroid treatment in patients who wish to preserve the uterus.