Ultrasound-guided high-intensity focused ultrasound ablation for adenomyosis: the clinical experience of a single center.
OBJECTIVE
To assess the midterm outcomes after ultrasound-guided high-intensity focused ultrasound (HIFU) ablation in treatment of patients with symptomatic adenomyosis.


METHODS
A prospective clinical trial.


METHODS
University teaching hospital.


METHODS
Seventy-eight patients with symptomatic adenomyosis.


METHODS
A single treatment session of ultrasound-guided HIFU ablation for adenomyosis.


METHODS
Dysmenorrhea and menorrhagia scores and the incidence of complications.


RESULTS
In all 78 patients, 84.6% tolerated the treatment procedure well with pain scores between 0 and 4. Treatment was terminated in only one patient because of increased blood pressure persistently. Sixty-nine patients have finished at least an 18-month follow-up; the mean follow-up time was 24.2 months. Nonperfused regions in lesions were observed in 60 (87.0%) patients on the enhanced magnetic resonance imaging scans. Scores for menorrhea and dysmenorrhea decreased. Clinical effectiveness of the treatment was observed in 62 women (89.9%) with varying degrees of symptomatic relief of dysmenorrhea. Eight patients had relapses. Twenty-two patients (28.6%) had 27 complications. Of these, four had two or more complications. Twenty-three events (85.1%) did not need medical intervention (Society of Interventional Radiology class A). No serious complications including death or major permanent injuries were observed.


CONCLUSIONS
Ultrasound-guided HIFU ablation may be a safe and effective noninvasive alternative in the treatment of symptomatic adenomyosis.
Department of Obstetrics and Gynecology, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China.
Min
M
Zhou
Jin-Yun
JY
Chen
Liang-Dan
LD
Tang
Wen-Zhi
WZ
Chen
Zhi-Biao
ZB
Wang
D000328:Adult; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D014463:Ultrasonography