A comparative study of complete ablation rate of ifbroid with different grade of blood supply using radio frequency and high-intensity focused ultrasound / 中华医学超声杂志（电子版）

ABSTRACT

Objective To compare the complete ablation rate of radiofrequency (RF) ablation and high-intensity focused ultrasound (HIFU) in the treatment of uterine ifbroids with different blood supply. Methods One hundred and ten patients with 146 uterine ifbroids in Xijing Hospital of the Fourth Military Medical University from January 2009 to December were randomly divided into two groups and treated with HIFU or RF respectively. Each group had 55 patients. All patients were examined by color Doppler lfow imaging before the treatment. The blood supply of ifbroids were semi-quantitatively classiifed into three grades including G1, G2 and G3. The HIFU group had 15 patients with 20 ifbroids in which blood supply was G1, had 32 patients with 38 ifbroids in which blood supply was G2, and had 8 patients with 10 ifbroids in which blood supply was G3. The RF group had 14 patients with 18 ifbroids in which blood supply was G1, had 31 patients with 42 ifbroids in which blood supply was G2, and had 10 patients with 18 ifbroids in which blood supply was G3. The complete ablation rates of the two treatments were evaluated by contrast-enhanced ultrasound one week before and after treatments. Fibroids which had no contrast agent perfusion and smooth boundary were completely ablated. Statistical analyses were used to compare the complete ablation rates and postoperative complications rates of these two methods. Results When ifbroid′s blood supply was G1, the complete ablation rate was 80.0%(16/20) and 88.9%(16/18) in HIFU and RF group, respectively. The difference was not statistically signiifcant (χ2=0.563, P>0.05). When ifbroid′s blood supply was G2 and G3, the complete ablation rate in HIFU and RF group was 90.5%(38/42) vs 55.3%(21/38) and 72.2% (13/18) vs 20.0% (2/10), respectively. There was statistically difference between these two groups (χ2 =12.778, P < 0.05;χ2=7.049, P < 0.05, respectively). Postoperative complications included fever, abdominal pain, pelvic effusion and vaginal discharge and unilateral lower limb numbness. The incidence of complications was lower in HIFU group than that in RF group, which was 9.1%(5/55) and 27.3%(15/55) respectively, This difference was statistically signiifcant (χ2=6.111, P<0.05). Conclusions HIFU and RF are both effective in treating uterine ifbroids with few blood supply. However, RF can be more effective than HIFU in treating hypervascular ifbroids. Therefore, RF might be able to apply to majority of the ifbroids. As a non-invasive therapy, HIFU is more suitable for hypovascular ifbroids and could be the ifrst therapy in clinic.