The Relationship Between The Situation Of Dysmenorrhea Improvement After The Treatment Of High Intensity Focused Ultrasound In Adenomyosis And The Features Of The Lesions

Objective: Analyzing the features of the lesions(including the number of hyperintenese foci of the adenomyosis lesions on the magnetic resonance imaging(MRI)on T2 weighted images(T2WI),the locations of the lesions in the uterus and the thickness of the junctional zones)in patients with adenomyosis before the treatment of high intensity focused ultrasound,and the non-perfused volume(NPV)ratio of the lesions and the dysmenorrhea changes after the treatment,this thesis observes the relationship between the situation of dysmenorrhea improvement after the treatment of high intensity focused ultrasound in adenomyosis and the features of the lesions.Methods: 91 patients with adenomyosis who were were voluntary selection of high intensity focus Ultrasound treatment in the Department of Obstetrics and Gynecology,Affiliated Hospital of North Sichuan Medical College from January 2018 to December 2018 were selected as subjects.All patients’ features of the lesions(including the number of hyperintenese foci of the adenomyosis lesions on the MRI on T2 WI,the location of the lesions in the uterus and the thickness of the junctional zones)were evaluated before the treatment.We calculated the NPV ratio by the enhanced MRI in the second day after the treatment and the situation of dysmenorrhea improvement after treatment for one month.The dysmenorrhea score before and after the treatment,the situation of dysmenorrhea improvement and the NPV ratio were compared in groups of different number of hyperintenese foci of the adenomyosis lesions on T2 WI and different locations of the lesions on the uterus.Then correlation analysis was performed between the above indicators and the thickness of the junctional zones.Results:(1)All the 91 patients successfully completed HIFU treatment,and the symptoms of dysmenorrhea were significantly relieved after the treatment(p<0.05),and no serious complications occurred;(2)The degree of dysmenorrhea improvement and the NPV ratio in the group with few hyperintense foci(thenumber of hyperintense foci <5)on T2 WI were significantly higher compared to the group with multiple hyperintense foci(the number of hyperintense foci >5)(p < 0.05);(3)In patients with adenomyosis with lesions located at the bottom of the uterus,there was a correlation between the thickness of the junctional zones and the NPV ratio(p<0.05)(The correlation coefficient were-0.48);(4)The NPV ratio in the group with the adenomyosis lesions in the anterior wall of the uterus was significantly higher than the groups with the lesions in the posterior wall of the uterus and the bottom of the uterus(p<0.05).There was no significant difference in the degree of dysmenorrhea in groups with adenomyosis lesions located in different locations of the uterus(p>0.05);(5)The thickness of the junctional zones on T2 WI had no significant correlation with the dysmenorrhea score before and after the treatment,the degree of dysmenorrhea improvement and the NPV ratio(p>0.05);(6)There was no significant correlation between the NPV ratio and the degree of the dysmenorrhea improvement(p>0.05).Conclusions:(1)HIFU treatment can significantly improve the dysmenorrhea symptoms in patients with adenomyosis;(2)The number of hyperintenese foci of the adenomyosis lesions on the MRI on T2 WI may be used as a predictive factor influencing the dysmenorrhea improvement after HIFU treatment in patients with adenomyosis,and provide a basis for the optimization of HIFU in the treatment of adenomyosis.