Effect of the degree of magnetic resonance‐guided high‐intensity focused ultrasound ablation of uterine fibroid tissue on 6‐month volume reduction

Abstract

Dynamic contrast enhanced; Hyper-vascular fibroids; Magnetic resonance-guided high-intensity focused ultrasound ablation; Uterine fibroids Tissue perfusion in uterine fibroids has been identified as an important factor in determining the outcome of magnetic resonance (MR)-guided high-intensity focused ultrasound ablation and previous studies 1-4 have identified that the effective ablation of hyper-vascular tissue inside fibroids could significantly impact on treatment outcomes. The aim of the present study was to explore if ablation outcomes were affected by fibroids being either hypo-or hyper-vascular. The present retrospective study included data from 53 patients (mean age 43.6 years [range 30-51 years]) with 67 fibroids (mean maximum diameter 5.7 cm [range 3.2-10.4 cm], mean volume 161.2 cm 3 [range 29.7-698.9 cm 3 ]) who underwent successful MR-guided highintensity focused ultrasound ablation using a 3.0-T MR system (Philips, Best, the Netherlands) at Peking Universtiy First Hospital, Beijing, China. All participants underwent MR scanning to assess fibroid volume at baseline before ablation and at 6-month follow-up. All fibroids were classified into two groups at baseline according to dynamic contrast-enhanced MR images: a hyper-vascular fibroid group (defined by homogenous enhancement occurring at or above the uterine layer or more than 50% of a heterogeneously enhanced region being above the uterine layer) and a hypo-vascular fibroid group (defined by T A B L E 1 Fibroid-ablation outcomes. a