The Efficacy And Safety Of SonoVue? Combined With High Intensity Focused Ultrasound In The Treatment Of Adenomyosis

Adenomyosis is a common disadvantage for women’s health.There are all obvious defects in surgical resection and drug treatment.High intensity focused ultrasound(HIFU)as a micro-noninvasive method for the treatment of adenomyosis has achieved a good clinical effect.However,adenomyosis is more difficult to ablate than uterine fibroids,so it has been a hot topic of study to improve the efficiency of HIFU in adenomyosis and ensure its safety.Sono Vue? is a microbubble ultrasound contrast agent widely used and clinically available in China.It can not only better observe the boundary and range of ablation,but also increase the efficiency of ablation by cavitation effect and thermal effect.Objective:To evaluate the clinical usefulness of the microbubble contrast agent Sono Vue? in enhancing high intensity focused ultrasound(HIFU)for the treatment of adenomyosis,to provide a basis for reasonable application of Sono Vue? to improve the efficiency of HIFU ablation.Materials and methods:A total of 102 patients with adenomyosis,assessed from August 2015 to April 2017,were randomly divided into 1 minute(A)and 10 minutes(B)groups,respectively.In groups A and B,HIFU started 1 minute and 10 minutes,respectively,after Sono Vue? and normal saline mixture 2ml injection.All patients underwent magnetic resonance imaging scan before and after HIFU treatment.Results:The occurrence rates of massive grey-scale change,non-perfused volume,and fractional ablation were similar in both groups(P>0.05).Meanwhile,sonication time to massive grey-scale change was reduced in group A compared with group B(P<0.05).In addition,average power,total energy,and energy efficiency factor(EEF)were lower in group A than group B(all P<0.05).The incidence rates of most perioperative-and all postoperative adverse events were similar in both groups(P>0.05).The incidence rates of pain in the treated region,leg pain,and sciatic or buttock pain during HIFU were significantly lower in group A than group B(P<0.05).Conclusions:Overall,starting HIFU sonication at 1 minute after SonoVue? injection enhances HIFU ablation by cavitation and heating,and is safe.Early massive grey-scale change,lower total energy,and reduced average power are potential safety factors.