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Contrast-Enhanced Ultrasound for Evaluation of High-Intensity Focused Ultrasound Treatment of Benign Uterine Diseases

机译:超声造影评价高强度聚焦超声治疗良性子宫疾病

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摘要

As a noninvasive treatment technique, ultrasound-guided high-intensity focused ultrasound (HIFU) has been considered as a routine treatment for uterine fibroids and adenomyosis in China. Contrast-enhanced ultrasound (CEUS) has been proposed as another option to assess the treatment efficacy during HIFU treatment. The aim of this investigation is to evaluate the adverse effects of HIFU ablation for benign uterine diseases in a group of patients studied with ultrasound contrast agent (UCA), in comparison with a group of patients not exposed to UCA. From November 2010 to December 2013, 2604 patients with benign uterine diseases were treated with HIFU. Among them, 1300 patients were exposed to an UCA, whereas 1304 patients were not.During HIFU procedure, the incidences of leg pain, sacral/buttock pain, groin pain, treatment area pain, and the discomfort “hot” sensation on skin were higher in the patients who were exposed to SonoVue (Bracco, Milan, Italy) than those who were not (20.5% vs 11.7%, 52.5% vs 42.3%, 6.5% vs 4.5%, 68.9% vs 55.4%, and 48.1% vs 42.9%, respectively). Among the postoperative adverse effects, the incidence of lower abdominal pain was significantly higher in patients who were exposed to an UCA than those who were not (51.2% vs 39.9%, P < 0.05). Two patients who were exposed to an UCA had acute renal function failure.In conclusion, UCA may increase the incidences of some common HIFU-related adverse effects during HIFU treatment for benign uterine diseases, but most of which were acceptable and self-limited. After HIFU treatment, renal function should be monitored in patients with a history of hypertension or taking nonsteroidal anti-inflammatory drugs.
机译:作为一种无创治疗技术,超声引导高强度聚焦超声(HIFU)在中国被认为是子宫肌瘤和子宫腺肌病的常规治疗方法。已经提出了对比增强超声(CEUS)作为评估HIFU治疗期间治疗效果的另一种选择。这项研究的目的是评估超声造影剂(UCA)与未接触UCA的一组患者相比,HIFU消融对良性子宫疾病的不良影响。从2010年11月至2013年12月,HIFU治疗了2604例良性子宫疾病患者。其中,有1300例患者接受了UCA,而没有1394例患者。在HIFU手术期间,腿痛,/臀部痛,腹股沟痛,治疗部位疼痛和皮肤不适感“热”的发生率更高。接触SonoVue(布拉科,米兰,意大利)的患者比未接触者(20.5%对11.7%,52.5%对42.3%,6.5%对4.5%,68.9%对55.4%和48.1%对42.9 %, 分别)。在术后不良反应中,接触UCA的患者下腹部疼痛的发生率明显高于未接触UCA的患者(51.2%vs 39.9%,P <0.05)。两名暴露于UCA的患者发生了急性肾功能衰竭,总的来说,UCA可能会增加HIFU治疗良性子宫疾病期间一些常见的HIFU相关不良反应的发生率,但大多数是可以接受的并且是自我限制的。 HIFU治疗后,有高血压病史或服用非甾体类抗炎药的患者应监测肾功能。

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