Focused Ultrasound For Uterine Fibroids Of < 4cm:Efficacy、Safety

Background:Uterine fibroids are the most common benign tumors in reproductive age women. The prevalence of uterine fibroids is 20-40%. With the development of diagnostic technology more and more patients with fibroids are diagnosed when the fibroids are< 4cm. Treatment for uterine fibroids includes medicine, surgery, high intensity focused ultrasound, radiofrequency ablation, and microwave. HIFU has more advantages with other treatments. HIFU can ablate the target fibroids accurately by its thermal、mechanical and cavitation effects, without damage to the surrounding structures. So patients can have more concise and non-invasive treatment for such uterine fibroids. Theroticly, HIFU treatment for smaller fibroids takes less energy, shorter sonication time, and it will take less time to absorb the treated tumor. At present, there are less reports about fibroids of< 4 cm, and no longer-term follow-up. The aim of this study was to evaluate the safety、efficacy and long-term follow-up results of HIFU treatment for uterine fibroids of<4cm, provide the basis for optimizeing the indications of HIFU.Materials and methods:1. From January 2011 to February 2013, seventy-nine patients with a solitary uterine fibroid of< 4cm from suining central hospital of sichuan was treated with HIFU.2. Contrast-enhanced ultrasound are used to evaluate the non-perfused volume of the fibroids immediately after HIFU. Adverse effects were recorded. After HIFU treatment, the patients were followed up at 1,3,6,12, 18,24 months. The fibroids shrinkage rate, uterine fibroid symptoms and quality of life (UFS-QOL) score are evaluated.Results:1. All the 79 cases with uterine fibroids completed HIFU treatment successfully. The median diameter of fibroids was 3.0cm. The median fibroid volume was 11.8 cm3 and the median non-perfused volume immediately after HIFU treatment was 9.6 cm3. The Median NPV rate was 87.1%. The median sonication time was 452s.2. The average shrinkage rate of uterine fibroids was 79.0%. UFS-QOL showed the symptoms and quality of life improved; No serious adverse effects occurred.Conclusion:1. HIFU ablation is safe and effective in treating uterine fibroids of< 4cm;2. After HIFU treatment, the high absorption rate, and low recurrence rate, the sustain symptom relieve was observed.