Contrast‑enhanced ultrasound is better than magnetic resonance imaging in evaluating the short‑term results of microwave ablation treatment of uterine fibroids

Zhang,Yan; Zhang,Meiwu; Fan,Xiaoxiang; Mao,Dafeng

doi:10.3892/etm.2017.5171

Contrast‑enhanced ultrasound is better than magnetic resonance imaging in evaluating the short‑term results of microwave ablation treatment of uterine fibroids

Authors:
- Yan Zhang
- Meiwu Zhang
- Xiaoxiang Fan
- Dafeng Mao
View Affiliations

Affiliations: Department of Interventional Therapy, Ningbo No. 2 Hospital, Ningbo, Zhejiang 315010, P.R. China
Published online on: September 21, 2017 https://doi.org/10.3892/etm.2017.5171
Pages: 5103-5108

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Contrast‑enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) were compared in evaluating the short‑term effects of microwave ablation (MWA) on uterine fibroids. A total of 60 patients with uterine fibroids treated by MWA were enrolled in the experimental group during their two‑year follow‑up period according to the inclusion criteria. Conventional two‑dimensional US, MRI and CEUS were performed to determine the volume reduction and the fibroid residue by displaying the size, echo and signal intensity of fibroids prior to and after MWA treatment. As the control group, 60 consecutive patients were recruited on their follow‑up visit at least two years after MWA treatment of uterine fibroids. Significant differences were observed in the wash‑in rate (WiR) of the fibroid tissue, start time difference, rise time ratio (RTR) and WiR ratio between the experimental and control groups (P<0.05). However, the WiR of fibroid vessel, total area under the curve of fibroid vessel and tissue, and rise time difference (RTD) between fibroid vessel and tissue did not display any significant differences between the two groups. Fibroids were either reduced in volume or cured by MWA therapy in patients with uterine fibroids. The reductions in volume of hypointense, isointense and hyperintense fibroids were 62.42±18.13, 53.27±10.05 and 47.43±9.56%, respectively, on T1‑weighted imaging (T1WI). On T2WI, the corresponding reductions were 67.32±32.63, 59.36±19.36 and 42.63±10.37%, respectively. The higher the signal intensity on T1WI and T2WI, the lower the reduction in volume. It is indicative that different blood supply to fibroids results in different ablation. CEUS was proved to be more effective than MRI in evaluating the effects of MWA on uterine fibroids during the first postoperative year.

View Figures

View References

1	Talaulikar VS and Manyonda I: Progesterone and progesterone receptor modulators in the management of symptomatic uterine fibroids. Eur J Obstet Gynecol Reprod Biol. 165:135–140. 2012. View Article : Google Scholar : PubMed/NCBI
2	Olejek A, Olszak-Wąsik K and Czerwinska-Bednarska A: Long-term intermittent pharmacological therapy of uterine fibroids-a possibility to avoid hysterectomy and its negative consequences. Prz Menopauzalny. 15:48–51. 2016.PubMed/NCBI
3	Carrafiello G, Recaldini C, Fontana F, Ghezzi F, Cuffari S, Laganà D and Fugazzola C: Ultrasound guided radiofrequency thermal ablation of uterine fibroids: Medium-term follow-up. Cardiovasc Intervent Radiol. 33:113–119. 2010. View Article : Google Scholar : PubMed/NCBI
4	Ankem K: Information-seeking behaviour of women in their path to an innovative alternate treatment for symptomatic uterine fibroids. J Med Libr Assoc. 95:164–172. 2007. View Article : Google Scholar : PubMed/NCBI
5	Estrade-Huchon S, Bouhanna P, Limot O, Fauconnier A and Bader G: Severe life-threatening hemoperitoneum from posttraumatic avulsion of a pedunculated uterine leiomyoma. J Minim Invasive Gynecol. 17:651–652. 2010. View Article : Google Scholar : PubMed/NCBI
6	Ellens N and Hynynen K: Simulation study of the effects of near- and far-field heating during focused ultrasound uterine fibroid ablation using an electronically focused phased array: A theoretical analysis of patient safety. Med Phys. 41:0729022014. View Article : Google Scholar : PubMed/NCBI
7	Chen XM and Luo PF: Current status, questions and challenges of transcatheter uterine artery embolization for the treatment of uterine fibroids. J Int Radio. 15:449–450. 2006.
8	Ren XL, Zhou XD, Zhang J, He GB, Han ZH, Zheng MJ, Li L, Yu M and Wang L: Extracorporeal ablation of uterine fibroids with high-intensity focused ultrasound: Imaging and histopathologic evaluation. J Ultrasound Med. 26:201–212. 2007. View Article : Google Scholar : PubMed/NCBI
9	Ghezzi F, Cromi A, Bergamini V, Scarperi S, Bolis P and Franchi M: Midterm outcome of radiofrequency thermal ablation for symptomatic uterine myomas. Surg Endosc. 21:2081–2085. 2007. View Article : Google Scholar : PubMed/NCBI
10	Dong BW, Liang P, Yu XL, Yu DJ, Zhang J, Feng L, Cheng ZG, Wang Y and Wang ZL: Long-term results of percutaneous sonographically-guided microwave ablation therapy of early-stage hepatocellular carcinoma. Zhonghua Yi Xue Za Zhi. 86:797–800. 2006.(In Chinese). PubMed/NCBI
11	Liang P, Wang Y, Zhang D, Yu X, Gao Y and Ni X: Ultrasound guided percutaneous microwave ablation for small renal cancer: Initial experience. J Urol. 180:844–848. 2008. View Article : Google Scholar : PubMed/NCBI
12	Zhang J, Feng L, Zhang B, Ren J, Li Z, Hu D and Jiang X: Ultrasound-guided percutaneous microwave ablation for symptomatic uterine fibroid treatment-a clinical study. Int J Hyperthermia. 27:510–516. 2011. View Article : Google Scholar : PubMed/NCBI
13	Zhang J, Feng L, Zhang BS, Ren JT, Li ZC, Wen B, Hu DM, Jiang X and Du LD: The study of percutaneous microwave coagulation for uterine myomas. Chin J Med Ultrasound (Electronic Edition). 8:40–43. 2011.
14	Wang F, Zhang J, Han ZY, Cheng ZG, Zhou HY, Feng L and Hu DM: Imaging manifestation of conventional and contrast-enhanced ultrasonography in percutaneous microwave ablation for the treatment of uterine fibroids. Eur J Radiol. 81:2947–2952. 2012. View Article : Google Scholar : PubMed/NCBI
15	Huang JL, Xiong WL, Deng LW and Cheng GX: The diagnostic value of MRI in adenomyosis. Chin J CT & MRI. 23:1417–1419. 2015.
16	Wei CF, Hu B and Jiang LX: Evaluation of uterine adenomyoma treatment with high intensity focused ultrasound by contrast-enhanced ultrasound. Chin J Med Ultrasound (Electronic Edition). 7:54–59. 2010.
17	Zhu Li, Chen WZ, Chen JY, Wen HY, Deng YB, Zhang R and Wang ZB: Study on the relationship between ultrasound ablation for uterine fibroids and signal of MRI. Acta Acad Med Militaris Tertiae. 14:1370–1373. 2009.
18	Hindley J, Gedroyc WM, Regan L, Stewart E, Tempany C, Hynyen K, Mcdannold N, Inbar Y, Itzchak Y, Rabinovici J, et al: MRI guidance of focused ultrasound therapy of uterine fibroids: Early results. AJR Am J Roentgenol. 183:1713–1719. 2004. View Article : Google Scholar : PubMed/NCBI
19	Zhou XD, Ren XL, Zhang J, He GB, Zheng MJ, Tian X, Li L, Zhu T, Zhang M, Wang L and Luo W: Therapeutic response assessment of high intensity focused ultrasound therapy for uterine fibroid: Utility of contrast-enhanced ultrasonography. Eur J Radiol. 62:289–294. 2007. View Article : Google Scholar : PubMed/NCBI
20	Zhang X, Peng S, Chen JY and Zhang RT: Investigation on influence factors of ultrasound ablation in treating multiple uterine fibroids. J Minimally Invasive Med. 03:2014.
21	Yan LM, He J, Huang GH, He M, Li KQ and Zhang L: High intensity focused ultrasound ablation for uterine fibroids in patients with retroposition of uterus. Zhongguo Chao Sheng Yi Xue Zazhi. 28:72–74. 2012.