Enhancing Ablation Effects Of A Microbubble Contrast Agent("Sono Vue”) In The Treatment Of Uterine Fibroid With High Intensity Focused Ultrasound

Objectives: To explore the clinical value of the microbubble contrast agent(‘‘Sono Vue’’) in the treatment of uterine fibroid with High Intensity Focused Ultrasound(HIFU), and evaluate the safety and efficacy of the contrast agent enhancing the outcome of HIFU ablation.Methods: A total of 120 patients with solitary uterine fibroid at a single center were randomly divided into A、B、C、D groups. Each group received a different treatment(1.5ml Sono Vue,1.5ml Normal Saline)in different start time(6min,10min) of HIFU ablation. Recording the average age of patients、the location of uterine fibroid、the maximum diameter of fibroid、the numbers of MRI T2 signal intensity of fibroid and fibroid volume in each group. Sonication power(400W) was used during HIFU ablation, Recording each group’s treatment time、sonication time、sonication time per hour、the rate of massive gray scale changes、the sonication time to achieve massive gray scale changes and the adverse events during the HIFU procedure. Post-treatment MRI occurred one day after HIFU ablation to calculate the non-perfused volume and fractional ablation. By telephone or outpatient follow-up to understand the adverse events after the HIFU procedure Within 1 week.Results: 120 patients were successfully completed HIFU treatment, There were no significant differences in the average age、location of uterine fibroid( Anterior/Posterior/Lateral/Fundus)、 the maximum diameter of fibroid、 MRI T2 signal intensity of fibroids(High/Intermediate/Low) or volume of fibroid among the four groups. According to the results of Factorial Analysis: compared with Normal Saline, it can significantly shorten the treatment time( Fdrug=37.955,P<0.01)and the sonication time( Fdrug=33.982,P<0.01)of the HIFU ablation after dministrated a bolus of Sono Vue via hand vein injection. And then, Compared with 10 min, it also had obvious influence on the treatment time( Ftime=6.389,P=0.013)and the sonication time( Ftime=4.335,P=0.04)that HIFU ablation started in 6 min. In addition, the Sonovue and starting time had obvious interaction on improving the teatment time( Ftime*drug=4.564, P=0.035) and the sonication time( Ftime*drug=4.107,P=0.045). Prompted it can significantly improve the treatment time and the sonication time when HIFU ablation was started 6min after the injection of 1.5ml Sono Vue. Moreover, it also can enhance the rate of massive gray scale changes(55.9%)and fractional ablation(94.2±10.6%)when HIFU ablation was started 6min after the injection of 1.5ml Sono Vue. No significant difference in the average number of adverse symptoms of intraoperative and postoperative adverse events among the four groups(P>0.05).Conclusions: Based on our results, the Sono Vue may enhance the ablation effects of HIFU treatment uterine fibroid, the Sono Vue can safely used to enhance the effects of HIFU treatment for uterine fibroids when HIFU ablation was performed 6min after administrated a bolus of 1.5 ml Sono Vue via hand vein injection.