Therapeutic Effects Of Hifu Intensity Focused Ultrasound Treatment For Adenomyosis

BackgroundAdenomyosis is a common benign gynecological disease. Endometrialglands and stroma deeply locate within the myometrium and develop intoadenomyosis. It is caused by the injury of basal layer of the myometriumand the stimulation of the high levels of estrogen.Multiparas whose ageranging from30to50years are susceptible to adenomyosis. Patientsusually have dysmenorrhea more and more serious, menorrhea andinfertility. These symptoms significantly affect the quality of life ofpatients with adenomyosis. Currently, the therapeutic methods foradenomyosis mainly include surgery and medicine. The medicine areappropriate for the patients with minor symptoms or desiring pregnancy orclose to menopausal. The hysterectomy is a radical method for someparients with severe symptoms or completed family plan or no remissionafter medicine. The conservative operations and the high intensity focusedultrasound (HIFU) ablation improve the quality of life of patients whilecomplications were low. HIFU is a non-invasive therapeutic method fortumor. The conventional ultrasound beam is focused in a tight focus, and the temperature at the focus can rise above60℃for1second, which willlead to coagulative necrosis of the tissue at the focus, and the neighbouringtissue will not be damaged. This technology is a new therapeutic methodfor adenomyosis.Objective：1. To retrospectively investigate the clinical efficacy of high intensityfocused ultrasound (HIFU) ablation for patients with adenomyosis.2. To compare the therapeutic effects and adverse effects of highintensity focused ultrasound (HIFU) ablation for adenomyosis on theantetheca and paries posterior of uterus.Methods：1. Retrospective analysis of fifty-eight patients with adenomyosis whounderwent HIFU treatment from the First Hospital of Chongqing MedicalUniversity. The patients were followed up at1month,3month,6monthand12month after HIFU ablation, and the symptoms were recorded.2. Forty-five patients with adenomyosis who underwent HIFUablation in the First Hospital of Chongqing Medical University.Thepatients were classified as the adenomyosis on the antetheca of uterus andthe adenomyosis on the paries posterior of uterus. To compare the energy,treatment time, sonication time required to ablate1cm3Adenomyosis,Energy-Efficiency Factor(EEF), Non-Perfused Volume and the adverseeffects in two groups. Results1.The average dysmenorrhea score and the average menstrual bloodvolume score decreased significantly at1month,3month,6month and12month after HIFU treatment,and the patients with anemia took a turn forthe better after HIFU treatment.2. About the energy, treatment time, sonication time required to ablate1cm3adenomyosis tissue, Energy-Efficiency Factor(EEF), Non-PerfusedVolume and the adverse effects, no significant difference was observedbetween the patients with adenomyosis on the antetheca of uterus and thepatients with adenomyosis on the paries posterior of uterus.Conclusions：1.HIFU is a new effective and safe treatment method for adenomyosis,and significantly alleviate the symptoms of the patients with adenomyosis.2. The location of the adenomyosis will not influence thetherapeuticeffects of HIFU ablation for adenomyosis, HIFU appears to be alternativetreatment for both the adenomyosis on the antetheca and the pariesposterior of uterus.