| Objective:To compare the clinical effects and secuitity of HIFU treatment for adnomyosis with different strengthening degrees in contrast enhanced MRI at the early arterial phase.Methods:Sixty-three patients with adnomyosis who underwent HIFU ablation in the First Hospital of ChongQing Medical University were included in this study. Depending on the strengthening degree of Contrast-enhanced MRI at early arterial phase, they weredivided into mild contrast-enhanced group and significantly contrast-enhanced group.There were 32 cases in Mild strengthen group. All of themhave dysmenorrheaand 22 cases had an increased amount of menstruation; There were 31 cases in the group of obviously strengthen, dysmenorrhea in 30/31 and 17/31 with an increased amount of menstruation. pituitrin (80 u) were used in all patients in the treatment. the dosimetry parameter (average power, total energy, irradiation time and so on) of two groups of patients were compared. the influences of different strengthening degrees of contrast enhanced MRI at early arterial phaseto EEF were analyzed. the incidence ratesof adverse events within three days after treatment between the two groups were compared. the improvement of clinical symptoms in 1,3,6 months after treatment in the two groups was followed up and compared.Results1.Two groups of patients were successfullytreated. The EEF of mild contrast-enhanced group and significantly contrast-enhanced was 6.97±6.62 (J/mm3),23.64±42.57 (J/mm3), respectively.The NPVR of the two groups was 65.04±17.41 (%)and 49.26 ± 21.82(%)respectively.There exists a significant difference of EEF. NPVR?energy?irradiation time between the two groups (P< 0.05). There existed no difference inaverage power andcure strength between the two groups(P>0.05).2.In the treatment, strong echo appeared in 31 cases (97%) of the mild strengthen group, and the irradiation time was 141 ± 370 seconds. strong echo appeared in 28 cases (90%) in obvious strengthening group,and the irradiation time was 155±305 seconds. There was no significant statistical difference in the two groups (P> 0.05).3. no severe side effects occured after treatment in the two groups.There were no significant difference in the pain of sacral tail, the pain of treatment are and other side effects in the two groups (P> 0.05).In addition, one case of obviously strengthen group had urethra tingling.After HIFU treatment, the pain of abdominal,the pain of the tail, vaginal drainage, lower limb movement, sensory dysfunction, fever, skin damage and other complications between the two groups had no significant statistical difference(P> 0.05).But the cases of vaginal drainage in mild strengthen group were more than that in obvious strengthening group.In addition, one case of urinary retention was observed in mild contrast-enhanced group.4.Evaluating the curative effect of the two groups in 1,3,6 months after HIFU treatment.Mild contrast-enhanced group and significantly contrast-enhanced group lost 5 cases,3 cases,4 cases, and 5 cases,4 cases, 4 cases,respecttively.Except for lcase in contrast-enhanced group,3cases in significantly contrast-enhanced group, treatment of all patients were effective.And there were not significant between the two groups (P> 0.05).Conclusions:1.EEF is significantly different in different strengthening degrees of contrastenhanced MRI at early arterial phase in adenomyosis.It's higher in significantly contrast-enhanced than in mild contrast-enhanced of MRI in adenomyosis.2.There is no significant difference in side effects and adverse reactions on different blood supply in HIFU treatment.3.The clinical effect of HIFU is sure in significantly contrast-enhanced MRI adenomyosis.But it still needs to be the long-term curative effect observation. |
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