Value of 3D color power angiography in evaluating the efficacy of high intensity focused ultrasound in treatment of uterine leiomyomas

Objective To evaluate value of 3D color power angiography for the efficacy of high intensity focused ultrasound (HIFU) in treatment of uterine leiomyomas.Methods Seventeen patients with 21 leiomyomas were treated with HIFU. The 3D color power angiography combined with conventional ultrasound was performed within twenty-four hours before and after application of HIFU treatment. The vascularity of leiomyomas was classified by 3D color power angiography. The volumes of leiomyomas and patients' symptoms were observed within a 6-month follow-up (one time/one month). Results Before treatment,conventional ultrasound showed that 21 uterine leiomyomas in 17 cases appeared as hypoechoic or hypoechoic with heterogeneous sound,while 3D color power angiography showed the blood flow signs in all uterine leiomyomas as a spherical net structure. After treatment,all uterine leiomyomas became hyperechoic in conventional ultrasound images. The blood flow signs disappeared in 9 tumors and reduced in 10 ones by 3D color power angiography. Two tumors (in 2 cases),without any changes of flow signs after therapy in 3D color power angiographic images,were treated with HIFU. Seventeen patients (21 leiomyomas) were treated by HIFU. After 6-month treatment,the mean volume in all uterine leiomyomas decreased by 14%~95% (P0.05) from (100.4±62.1)cm3 before treatment to (45.3±35.8)cm3 after treatment. The symptoms were disappeared in 6 cases and improved in 11 after HIFU treatment. No outstanding adverse event was in 13 cases,skin vesicles in 3 cases and local swelling at skin scar in one case. Conclusions The 3D color power angiography is a new and practical tool to assess the efficacy of HIFU in treatment of uterine leiomyomas.