Synergistic Effect Of Dynamic Vascular Pattern For Sono Vue Combined With HIFU Ablation On Hyper-enhancing Fibroids

Objective:To investigate the synergistic opportunity,efficacy and safety of dynamic vascular pattem(DVP)in SonoVue combined with HIFU ablation of hyper-enhancing fibroids.Methods:We retrospectively collected data on 36 patients who were underwent HIFU at the First Affiliated Hospital of Kunming Medical University from July 2014 to October 2016 as control group(group ?);we prospectively collected 60 patients with hyper-enhancing uterine fibroids who were treated with HIFU from October 2016 to June 2018,and randomly divided them into non-DVP synergistic group(group ?)and DVP group(group ?).Ultrasound irradiation time,operative time,ultrasound gradation change time,ablation rate,energy efficiency factor(EEF),treatment efficiency,therapeutic dose,NPV and other treatment parameters were analyzed by one-way ANOVA and pairwise comparison to evaluate the three groups of patients.The synergistic effect and synergistic opportunity of DVP in SonoVue combined with HIFU ablation of hyper-enhancing fibroids.According to the SIR classification,the adverse events after HIFU treatment were counted in three groups of patients,and the comparison between groups was performed by line × list ? 2 test to evaluate the safety of DVP in the treatment of hyper-enhancing fibroids with SonoVue combined with HIFU.The patient's fibroid volume reduction rate,symptom score,quality of life score,and menstrual score were followed up at 6 months to evaluate the clinical efficacy of DVP in SonoVue combined with HIFU in the treatment of uterine fibroids.Results:(1)Baseline data such as age,distance from the fibroid to the skin,fibroid volume,number of fibroids,uterine location,fibroid location,fibroid type,MRI-T2WI,etc.were compared between group ?,group ?,and group ?.There were no significant differences(P>0.05).(2)Treatment parameters:Group ? vs group ?:The NPV of group ? was higher than that of group ?,and the EEF was lower than group I,the difference was statistically significant(P<0.05);Group ? vs group ?:The ablation rate,treatment efficiency,therapeutic dose and NPV of group ? were higher than group I,EEF was lower than group ?,the difference was statistically significant(P<0.05);Group ? vs group ?:The ablation rate and treatment efficiency of group ? were higher than that of group ?,and EEF was lower than group ?,and the difference was statistically significant(P<0.05).(3)Adverse events:adverse events such as lower abdominal pain,sacrum/buttock pain,erythema on skin,vaginal discharge,leg numbness/pain were compared between the three groups,and there was no statistical difference(P>0.05).(4)Clinical efficacy:baseline data such as symptom score,quality of life score,and menstrual score were compared between the three groups before treatment,and the difference was not statistically significant(P>0.05);Symptom scores,quality of life scores,menstrual scores and other parameters were compared between the three groups in the sixth month after treatment,and the difference was statistically significant(P<0.05).Conclusions:(1)Under the guidance of DVP,SonoVue combined with HIFU has synergistic effect to treat the hyper-enhancing fibroids.Under the DVP,it is the best HIFU ablation opportunity when SonoVue is concentrated in fibroids and cleared in surrounding tissues.(2)The incidence of adverse events in group III was low,and there was no C-F adverse event,suggesting that SonoVue combined with HIFU in the treatment of hyper-enhancing fibroids under the guidance of DVP did not increase the incidence of adverse reactions.(3)Under the guidance of DVP,SonoVue combined with HIFU treatment of uterine fibroids can significantly improve the patient's symptom score,quality of life score,and menstrual score,which can further improve its clinical efficacy.