Focused ultrasound treatment of uterine fibroid tumors: Safety and, feasibility of a noninvasive thermoablative technique

被引:323
作者
Stewart, EA
Gedroyc, WMW
Tempany, CMC
Quade, BJ
Inbar, Y
Ehrenstein, T
Shushan, A
Hindley, JT
Goldin, RD
David, M
Sklair, M
Rabinovici, J
机构
[1] Brigham & Womens Hosp, Ctr Uterine Fibroids, Dept Obstet Gynecol & Reprod Biol, Boston, MA 02115 USA
[2] Brigham & Womens Hosp, Dept Radiol, Boston, MA 02115 USA
[3] Brigham & Womens Hosp, Dept Pathol, Boston, MA 02115 USA
[4] Harvard Univ, Sch Med, Dept Obstet & Gynecol, Boston, MA 02115 USA
[5] Harvard Univ, Sch Med, Dept Radiol, Boston, MA 02115 USA
[6] Harvard Univ, Sch Med, Dept Pathol, Boston, MA 02115 USA
[7] St Marys Hosp, Dept Radiobiol, London, England
[8] St Marys Hosp, Dept Obstet & Gynecol, London, England
[9] Chaim Sheba Med Ctr, Dept Radiol, IL-52621 Tel Hashomer, Israel
[10] Chaim Sheba Med Ctr, Dept Gynecol, IL-52621 Tel Hashomer, Israel
[11] Charite, Med Ctr, Berlin, Germany
[12] Humboldt Univ, Berlin, Germany
[13] Hadassah Med Ctr, Dept Obstet & Gynecol, IL-91120 Jerusalem, Israel
[14] Hadassah Med Ctr, Dept Radiol, IL-91120 Jerusalem, Israel
关键词
uterine leiomyomas; magnetic resonance imaging;
D O I
10.1067/mob.2003.345
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: The purpose of this study was to determine the safety and efficacy of focused ultrasound surgery with magnetic resonance imaging guidance for the noninvasive treatment of uterine leiomyomas. STUDY DESIGN:. Fifty-five women with clinically significant uterine leiomyomas were treated. Pain and complications were assessed prospectively, and posttreatment magnetic resonance imaging was used to measure the treatment effects. Patients in three of the five centers underwent planned hysterectomy after treatment, which provided pathologic correlation of treatment. RESULTS: Seventy-six percent of the enrolled patients completed the full treatment session. All treatments were conducted in an outpatient setting with minimal discomfort for subjects and no major complications. Pathologic examination of the uterus confirmed that magnetic resonance imaging guidance provides the safe and accurate delivery of effective levels of thermal energy with a 3-fold increase in volume of histologically documented necrosis, compared with treatment volume (6.6 +/- 0.8 vs 18.4 +/- 3.9 mL, P < .005). CONCLUSION: Magnetic resonance imaging-guided focused ultrasound surgery appears to be a well-tolerated treatment for uterine leiomyomas.
引用
收藏
页码:48 / 54
页数:7
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