| Objective To assess the clinical efficacy and relative factors of High-intensity focused ultrasound (HIFU) ablation on uterine leiomyomas.Methods A total 147 patients with uterine leiomyomas treated by HIFU were followed up for 3 months. Ultrasonic imaging, magnetic resonance imaging and clinical evaluation were obtained preoperatively and after 3 months.Results 197 uterine leiomyomas in 147 patients accepted the HIFU ablation. The size of uterus and that of the leiomyoma decreased from 136.7±48.7cm3,52.5±52.8cm3 preoperatively to 119.5±35.8 cm3,36.2±40.2 cm3 with a single-leiomyoma effective rate of 64.4%after 3 months. Menstruation restored to normal in 70.6%of the patients; pelvic pressure disappeared in 78.7%of the patients within 3 months. According to the ablation ratio, the efficacies of≤20%,20-80%及≥80%are 16%,52%and 88%(p<0.01). The depths of the myomas greater or less than 9cm have different efficacies, which are 76%and 42%(p<0.001), respectively. Besides, the efficacy of myomas with sufficient blood supply is 70%, compared with the insufficient one 6%(p＜0.001). The efficacy of the anesthesia mode is 81%, while that of the non-anesthesia mode is 61%(p<0.05). However, the size of leiomyomas, the age of patients and the thickness of skin had no impacts on the final outcomes (p>0.05).Conclusion HIFU is a promising choice for the treatment of uterine leiomyomas. The clinical outcomes are related to the ablation ratio, depth, blood supply and therapeutic manners of the leiomyomas. |
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