Objective

To investigate the long-term reintervention of ultrasound-guided high intensity focused ultrasound (USgHIFU) treatment for uterine fibroids and analyze the factors affecting reintervention rate after USgHIFU.

Materials and methods

Three hundred and eight-one patients with uterine fibroids treated by USgHIFU at the third Xiangya Hospital of Central South University from April 2012 to December 2014 were retrospectively reviewed. The factors that affect the reintervention rate were analyzed.

Results

The mean follow-up time was 70.0 ± 9.0 months. During the follow-up period, 86.4% (329/381) of the patients reported symptomatic relief and the fibroids shrank after USgHIFU treatment. Seventy-nine patients received reintervention included myomectomy, a second session of HIFU, and hysterectomy. The overall reintervention rate was 20.7% (79/381). The reasons for reintervention included symptomatic recurrence in 50 (50/79, 63.3%) patients, psychological factors in 14 (14/79, 17.7%) patients, fertility requirement in three (3/79, 3.8%) patients, suspected uterine sarcoma in two (2/79, 2.5%) patients and others in 10 (10/79, 12.7%) patients. The reintervention rate has significant correlation with some factors including age, size, type and the signal intensity on T2 weighted image (T2WI) of the uterine fibroids.

Conclusion

USgHIFU for uterine fibroids is effective due to low reintervention rate in a long-term follow-up.

中文翻译：

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超声引导下高强度聚焦超声治疗子宫肌瘤的长期随访结果和再干预分析。

目的

目的探讨超声引导高强度聚焦超声（USgHIFU）对子宫肌瘤的长期再干预，并分析影响USgHIFU术后再干预率的因素。

材料和方法

回顾性分析2012年4月至2014年12月在中南大学湘雅三医院接受USgHIFU治疗的子宫肌瘤患者381例。分析了影响再干预率的因素。

结果

平均随访时间为70.0±9.0个月。在随访期间，USgHIFU治疗后86.4％（329/381）的患者报告症状缓解且肌瘤萎缩。接受再干预的79例患者包括子宫肌瘤切除术，第二次HIFU和子宫切除术。总体再干预率为20.7％（79/381）。再次干预的原因包括症状复发50例（50/79，63.3％），心理因素14例（14/79，17.7％），生育力需求3例（3/79，3.8％），疑似子宫肉瘤两名（2/79，2.5％）患者，其他十名（10/79，12.7％）患者。再介入率与某些因素密切相关，包括年龄，大小，类型和子宫肌瘤T2加权像（T2WI）上的信号强度。

结论

由于长期随访中再干预率低，USgHIFU对子宫肌瘤有效。