UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
■本研究纳入2017年7月至2023年1月在湘雅三医院接受HIFU消融术治疗的10例FH缺陷型子宫肌瘤患者。分析HIFU的疗效和不良反应。
■接受HIFU的患者的中位年龄为32.0岁(范围:28-41岁)。只有2例患者有单独的子宫平滑肌瘤,而其余8例患者有多发性子宫平滑肌瘤。最大肌瘤的中位直径为56mm(范围:41-99mm)。磁共振成像显示8例FH缺陷型子宫平滑肌瘤在T2WI上表现为混合强度,一个病人的信号不足,另一名患者在T2WI上表现出高强度。所有患者均在一个疗程中成功进行HIFU消融,无严重不良反应。HIFU治疗后,中位非灌注体积比(NPVR)为40%(30.0%-78.0%)。4例患者NPVR≥70%。HIFU消融术后3个月随访,8例患者中5例的临床症状与治疗前症状均有缓解。治疗6个月后,8例患者中有4例症状仍在缓解。到2024年3月,所有患者都接受了再干预。再干预率为20%,70%,在12、24和36个月时占90%,分别,HIFU消融后。
■HIFU是治疗FH缺陷型子宫肌瘤的一种安全可行的方法,大多数患者在治疗后短期内显示出有效的结果。然而,再干预率很高,长期影响有限。