The treatment effects of high intensity focused ultrasound on uterine leiomyoma

Objective To evaluate the therapeutic effects of HIFU on uterine leiomyoma. Methods Thirty-three patients with uterine leiomyoma were treated with HIFU in the study. The inner echoes,blood supplies and volumes of myomas in 25 non-operative patients were observed by the color Doppler flow imaging (CDFI) three months after treatment. Eight patients who received operation after HIFU treatment were observed 24 hours later via contrast-enhanced MRI. Histopathologic changes were compared before and after the HIFU treatment. Results The obvious necrosis in the area of uterine leiomyoma was treated with HIFU treatment and was observed in 8 operative patients after 24 hour therapy. The size of necrosis was in accordance with the size of the treatment areas. The cell degeneration and necrosis,nuclear hyperchromatism and pycnosis as well as microangiums injuries were observed in the uterine leiomyoma by the microscope. Twenty-five non-operative patients were followed up for 3-16 months after HIFU. The clinical symptoms were alleviated or recovered in 23 patients,among them; 4 patients had no evidence of residual tumor,and the tumor volume was decreased by 20.1%-94.3% in 19 patients; two patients had no change in the size of the tumor. Thirteen patients (13/33) had adverse effects (e.g. transient radiated pain) due to sacro-coccygeal nerve stimulation,rectal prolapse and bladder irritation. Moreover,2 patients experienced first-degree skin burn,which was self-limited without any treatment on the next day. Conclusions HIFU treatment is effective and safe on uterine leiomyomas,but long-term therapeutic effects were further needed.