Magnetic resonance imaging features influencing high-intensity focused ultrasound ablation of adenomyosis with a nonperfused volume ratio of ≥90% as a measure of clinical treatment success: retrospective multivariate analysis

Keserci, Bilgin; Duc, Nguyen Minh

doi:10.1080/02656736.2018.1516301

Cited by 32 publications

(34 citation statements)

References 39 publications

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“…Multivariate logistic regression analysis also confirmed that patients with diffuse adenomyosis had lower pregnancy rates after HIFU treatment (Table 7). This result is consistent with that of a previous study, which showed that diffused lesions required larger ablation areas, leading to more severe burning of the uterine endometrium, and a reduced non-perfused volume [38].…”

Section: Discussionsupporting

confidence: 93%

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A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision

Huang

Deng

Wei

et al. 2020

International Journal of Hyperthermia

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2020) A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision, International ABSTRACT Objective: The aim of this study was to compare the treatment effects of high-intensity focused ultrasound (HIFU) and laparoscopic excision (LE) in patients with adenomyosis and infertility. Materials and methods: A total of 93 patients with adenomyosis and infertility who were treated with HIFU (50 patients) or LE (43 patients) from January 2012 to January 2017 at the Third Xiangya Hospital of Central South University were retrospectively analyzed. Clinical characteristics including dysmenorrhea severity pain score, menorrhagia severity scores, reproductive outcomes, complications during pregnancy and delivery, adverse effects, surgical complications, and other clinical variables were compared between the HIFU and LE groups. Results: Of the total 93 patients with adenomyosis and infertility, 50 were treated with HIFU and 43 underwent LE. Both HIFU and LE treatments achieved significant relief of dysmenorrhea and menorrhagia. The total hospital stay was shorter in patients treated with HIFU than in those who underwent LE surgery. Neither HIFU nor LE treatment led to severe complications after treatment. Most importantly, patients treated with HIFU showed significantly higher pregnancy rates and natural conception rates than those who underwent LE surgery. Notably, in the HIFU treatment group, those with diffuse adenomyotic lesions had significantly lower postoperative pregnancy rates than those with focal adenomyosis. Conclusion: HIFU showed a safe and effective profile as a therapeutic management option for patients with adenomyosis. In comparison with LE, HIFU treatment achieved better postoperative reproductive outcomes. HIFU treatment should be encouraged and implemented in clinical practice. ARTICLE HISTORY

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Section: Discussionsupporting

confidence: 93%

“…Of the 50 patients, 8 (16%) were diagnosed with primary infertility, and 42 (84%) were diagnosed with secondary infertility. In the LE group, the average age of patients was 35 years (IQR [31][32][33][34][35][36][37][38]. Before LE treatment, their average uterine volume was 148.3 cm 3 (IQR 73.5-202.1).…”

Section: Patients' Characteristicsmentioning

confidence: 99%

A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision

Huang

Deng

Wei

et al. 2020

International Journal of Hyperthermia

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“…In addition, some patients are refractory to drug therapy. Although high intensity focused ultrasound (HIFU) and uterine arterial embolization (UAE) are both effective in the treatment of adenomyosis, yet, the therapeutic effects of these two techniques on adenomyosis still remain to be further investigated 12–16. As a matter of fact, only total hysterectomy can thoroughly treat adenomyosis.…”

Section: Introductionmentioning

confidence: 99%

<p>Comparisons of the efficacy and recurrence of adenomyomectomy for severe uterine diffuse adenomyosis via laparotomy versus laparoscopy: a long-term result in a single institution</p>

Zhu¹,

Chen²,

Che³

et al. 2019

JPR

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Purpose Studies have shown that adenomyomectomy can effectively treat women with adenomyosis in a short period of time. However, the long-term efficacy of adenomyomectomy has rarely been reported. The objective of this study was to determine whether laparotomy is superior to laparoscopic surgery in the long-term efficacy of double-flap method adenomyomectomy for severe diffuse adenomyosis. Methods Between March 2011 and September 2018, a total of 148 patients with severe uterine diffuse adenomyosis who underwent laparoscopic (group A, n=72) and laparotomic (group B, n=76) double-flap adenomyomectomy were recruited. Adenomyomectomy efficacy and adenomyosis recurrence after surgery between groups A and B were comparatively analyzed. Results The effective rate at 6-year follow up after surgery was higher in group B (75.0%) than that in group A (62.1%), while the 6-year cumulative recurrence rate was higher in group A (27.8%) than that in group B (17.1%), but the differences did not reach statistical significance between the two groups ( P >0.05). The recurrence rate was lower in patients who were treated with gonadotropin-releasing hormone agonist (GnRHa) plus Mirena or oral contraceptives post-surgically than that in patients who were treated with only GnRHa post-surgically in groups A (51.6% vs 9.8%, P <0.01) and B (33.3% vs 6.5%, P <0.05). Moreover, the recurrence rate of adenomyosis patients with endometriosis was higher than that of adenomyosis patients without endometriosis in group A (55.0% vs 17.3%, P <0.05) and group B (36.0% vs 7.8%, P <0.05). Conclusion The long-term outcomes of laparoscopic and laparotomic double-flap adenomyomectomy can be achieved for severe diffuse uterine adenomyosis, but laparotomy seems to have advantages over laparoscopy. Postoperative drug use may be beneficial to reduce the recurrence of adenomyosis, especially for adenomyosis with endometriosis.

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“…The calculate of Uterine volume used a formula based on an ellipsoid shape: L×W×AP diameter×0.52 [18]. the focal AM volume(v): v=1/6 π×a×b×c, and a, b, and c are diameters measured in orthogonal planes on T2W images [19]. The calculate of focal AM lesion ratio was focal AM lesion size/ uterine volume.…”

Section: Mri Protocolsmentioning

confidence: 99%

The Value of ESWAN in Diagnostic of Adenomyosis and Related Study about Dysmenorrheal

Cheng

Wang

et al. 2019

Preprint

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Background This retrospective study aimed (1) to evaluate the value of enhanced T2 star-weighted angiography (ESWAN) in diagnosis Adenomyosis(AM). And (2) to estimate the differences of focal AM patients lesion and the peripheral tissues region. And (3) analysis the correlation between the multiple indices of ESWAN and dysmenorrheal, focal AM lesion ratio.Methods Traditional MRI and ESWAN were performed on seventy-two clinically–diagnosed AM patients (fifty for focal and twenty-two for diffuse AM), and fifty-six normal adult woman. The ESWAN indices (magnitude value, phase value, R2* value and T2* value) measured on different regions of interest (ROIs) were analyzed. Measured the focal AM lesion size and Uterine volume by tradition MRI, and using visual analogue scale(VAS) measured dysmenorrheal level.Results The magnitude value, phase value, R2* value and T2* value of focal AM, diffuse AM, peripheral tissue in focal AM and normal myometrium were respectively 1176.20±367.70/1286.51±349.49/1139.61±426.69/1685.94±407.14, 0.0114±0.0438/0.0138±0.0182/0.0296±0.0858/0.0433±0.0869, 26.39±3.36/27.40±2.36/27.24±4.60/22.54±5.03, 39.83±5.47/37.49±3.48/38.67±7.09/43.39±8.94. The ESWAN indices by one-way ANOVA showed statistical difference with the normal myometrium and focal and diffuse AM(0.000, 0.027, 0.000, 0.002). Compared with the peripheral tissue, the focal AM indices were no statistical difference. The correlation between the dysmenorrheal level and phase value were statistical difference(0.018).Conclusions ESWAN sequence has fractional value in diagnosis AM by different indices. And the dysmenorrheal level could react the AM feature in certain degree.

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Magnetic resonance imaging features influencing high-intensity focused ultrasound ablation of adenomyosis with a nonperfused volume ratio of ≥90% as a measure of clinical treatment success: retrospective multivariate analysis

Cited by 32 publications

References 39 publications

A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision

A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision

<p>Comparisons of the efficacy and recurrence of adenomyomectomy for severe uterine diffuse adenomyosis via laparotomy versus laparoscopy: a long-term result in a single institution</p>

The Value of ESWAN in Diagnostic of Adenomyosis and Related Study about Dysmenorrheal

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