Objective To evaluate the safety, feasibility and one-year outcome of magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) in treating uterine fibroids. Methods MRgFUS was carried out in 21 female patients with symptomatic uterine fibroids, which was immediately followed by Tl-weighted fast spoiled gradient echo MRI scanning with the use of gadolinium - based contrast agent. The size of non-perfused area of the fibroids was measured in all patients, based on which the safety of the procedure and the ablation effect of the lesion were evaluated. Follow - up assessments were completed at one year after the treatment. The questionnaire about uterine fibroid symptoms and quality of life (UFS - QOL) was conducted, the symptoms severity score (SSS) was calculated, and the improvement of the symptoms and the occurrence of undesirable events related to the procedure were recorded. Pelvic MRI re - examination was made, and the size of the fibroids was compared with that determined before the treatment. Results A total of 23 fibroid lesions were detected in 21 patients. MRgFUS was successfully accomplished for all the 23 lesions. The mean operation time for each patient was 3 hours and 50 minutes. The mean non - perfused volume (NPV) on the treatment day was 62.86% (25% - 99%). No serious adverse events occurred during the treatment. Seventeen patients completed one-year follow-up. The mean SSS was reduced to 8.27 ± 6.06 (a reduction by 68.79%, P < 0.05). Follow-up MRI showed that the fibroids volume was reduced by 49.60% on average (P < 0.05). Conclusion As a kind of noninvasive technique, MRgFUS is a safe treatment forrnuterine fibroids with reliable short - term effectiveness.%目的 评价MRI引导下聚焦超声刀(MRgFUS)治疗子宫肌瘤的安全性、可行性及1年随访结果.方法 对21例症状性子宫肌瘤患者进行MRgFUS治疗.在治疗后即刻行子宫肌瘤增强MR扫描,测量每例肌瘤的无灌注区域体积,评价治疗安全性及病灶消融情况.术后1年随访进行子宫肌瘤症状-生活质量问卷(UFS-QOL)调查,分析症状严重度评分(SSS),统计患者症状改善及相关不良事件发生情况,并完成子宫肌瘤MRI复查,对比肌瘤前后体积变化.结果 对全部21例患者的23个子宫肌瘤成功进行了MRgFUS治疗,平均每例耗时3 h 50 min,平均每例肌瘤当天治疗后无灌注体积百分比62.86％(25％～99％),术中无严重并发症发生.17例患者接受了术后1年随访,平均SSS降低68.79％,复查MRI显示肌瘤体积平均缩小49.60％,差异均有统计学意义(P＜0.05).结论 MRgFUS无创治疗子宫肌瘤具有较高的安全性,近期疗效确切.
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