| Background:Uterine fibroids is the frequently-occurring disease childbearing age women of reproductive system, its etiology is not fully clear.Clinical symptoms is closely related to the size and growth areas, mainly for the quantity increase, menstrual extension, abdominal pain and pelvic compression, etc., High Intensity Focused Ultrasound(High Intensity Focused Ultrasound(HIFU) is the rise of new technology in ten years, for clinical provides a precise positioning, no skin incision noninvasive treatment, at present, has been widely used in the prostate, breast, uterine, liver, kidney, pancreas and so on various parts of the treatment of benign and malignant solid tumor [1].HIFU is a non-invasive means of physical therapy, the vast majority of patients with postoperative small trauma, postoperative recovery call invasive surgery is fast, and also kept their own organs the integrity of the above characteristics make women with HIFU technology gradually become the new choice for the treatment of uterine fibroids. Ultrasound contrast agents(Ultrasound microbubble contrast agent, Jane writing UCA), is a kind of can significantly enhance ultrasonic backscatter intensity of chemical agents,the main ingredient is micro bubbles, so we can also be referred to as "the micro bubbles". the first ultrasound contrast agents were obtained by hand vibration physiology saline, it can only show the right heart imaging, studies have shown ultrasound contrast agent can enhance the operation of the HIFU ablation effect,can be used as synergist of HIFU,but in the use of the main problems existing in ultrasound contrast agents in vivo metabolism of short time, for large tumor, the treatment effect is not satisfied,it was found that by intravenous pump bubble can solve this problem,but its safe use dosage and worrying,then, in turn, we might be able to understand effect of ultrasound contrast agents for different size of tumor is different also. Objective:Through analysis contrast preoperative use of microbubble ultrasound contrast agents(Sono Vue) with preoperative ultrasound contrast agents not used to study the different diameter of uterine fibroids synergistic strength effect of ultrasound contrast agent combined with HIFU. Material and methods:1. Retrospective analysis in January 2015- December 2015 at Suining central hospital diagnosis uterine fibroids and single sex in patients undergoing HIFU treatment.According to the diameter of the preoperative magnetic resonance imaging(MRI) is divided into group I, II,III, the diameter of < 3 cm for the group I, 3 cm in diameter or less 5 cm or less for group I, diameter > 5 cm for the group III.In group I, 25 patients with preoperative and postoperative angiography were randomly selected as a contrast group, random selection of 25 cases of preoperative imaging, only patients with postoperative imaging angiography as a group, I set a total of 50 patients were included in the study.The same method randomly selected 25 cases in group II and III respectively as contrast group and contrast group.So I, II, III groups, adopt the study for 150 cases of the patients.2. Compared the treatment time, sonication time, EEF, Non-perfused Volume(NPV) ratio and the adverse effects between contrast group and control group in the process of treatment of uterine fibroids. Results:1. in group I, preoperative imaging and treatment time scope of thepreoperative imaging not the P value is 0.034, statistically significant. More preoperative angiography and the average power for preoperative bef ore angiography imaging, EEF, melting rate, melting volume, clumps in ti me, time, irradiation time, intensity, dose, treatment the P values were great er than 0.05, had no obvious difference.in group II, preoperative imaging and preoperative not imaging of irra diation time, EEF, melt volume of P value is 0.041, 0.018, 0.029, respectiv ely, irradiation time, EEF and ablation volume statistical differences. More preoperative angiography and preoperative angiography not treatment time,average power, ablation rate, clumps occurrence time, occurrence rate, inte nsity, dose, treatment the P values were greater than 0.05, had no obvious d ifference.in group III, preoperative imaging with preoperative imaging not aver age power, irradiation time, EEF, treatment time, melting rate, clumps occu rrence time, occurrence rate, intensity, dose, treatment the P values were gr eater than 0.05, had no obvious difference.2. I and III group contrast group and the preoperative imaging not in p reoperative radiation pain, lumbosacral tail pain, skin care, treatment area p ain, groin pain, hip creases pain P values were greater than 0.05, had no stat istical difference; Group II preoperative angiography and not imaging in radiation incidence of pain, the P value is 0.004, statistically significant, the r emaining group of preoperative contrast group and the preoperative imagin g not pain, skin scald, at the end of the sacral pain treatment area, the incide nce of groin pain, hip creases pain P values were greater than 0.05, no statis tical difference. Conclusions:1. in the ultrasound contrast agent for less than 3cm and greater than 5 cm of fibroids of the synergistic effect is not obvious, for 3 ~ 5 cm of uterine fibroids may have certain synergy, so the size of the uterine fibroids is not the main factors affecting the strength of the ultrasonic synergy.2. I, II, III in the study of the different sizes of uterine fibroids, preoperative imaging and angiography no significant difference in the incidence of adverse events, and all research in patients with no serious complications occurred, so preoperative ultrasound angiography combined with HIFU treatment of uterine fibroids is security. |
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