ABSTRACT
OBJECTIVE: To evaluate the effects of the ultrasound contrast agent SonoVue in enhancing the ablative effects of Ultrasound-Guided high-intensity focused ultrasound (HIFU) on different sub-types of uterine fibroids. MATERIALS AND METHODS: In this study, 390 fibroids from 319 patients were retrospectively evaluated, among which 155 were treated with SonoVue and 235 were without SonoVue during HIFU ablation. The efficacy of HIFU was evaluated using magnetic resonance scanning (MRI) in all patients. RESULTS: The total ablation time to achieve the same non-perfused volume was significantly shortened with SonoVue. The average energy used and the acoustic energy for treating 1 mm(3) (EEF) was less when SonoVue is used as enhancing agent. The non-perfused volume (NPV) was measured by post-HIFU MRI and the mean fractional ablation was calculated. Mean NPV was 74% (range: 15%-100%) in the HIFU-only group and 75% (range: 17%-100%) in the HIFU+ SonoVue group. However, for T2 MRI low intensity signal fibroids, NPV in the SonoVue group reached 83% (range: 20%-100%) that was significantly higher than in the HIFU-only group, which was 76% (range: 15%-100%). No differences in adverse events were observed between the two groups. CONCLUSIONS: Our observations demonstrate that the use of therapeutic SonoVue during the HIFU procedure can significantly decrease the ablation time and the energy requirement for the treatment of the same fibroid volume in all types of fibroids.
Subject(s)
Contrast Media/therapeutic use , High-Intensity Focused Ultrasound Ablation/methods , Leiomyoma/surgery , Microbubbles , Adult , Female , High-Intensity Focused Ultrasound Ablation/adverse effects , Humans , Middle Aged , Retrospective Studies , Treatment OutcomeABSTRACT
El varicocele es la dilatación varicosa de la vena espermática y del plexo pampiniforme. Se origina más frecuentemente en el lado izquierdo(10:1) como consecuencia de un mal funcionamiento o ausencia delas válvulas de la vena espermática izquierda. Entre marzo del 1999 y diciembre del 2009 se han recogido un total de 37 casos (17,9%) de los diagnosticados de varicocele en la población pediátrica de nuestro centro, que requirieron tratamiento. Mediante anestesia local se crea un acceso femoral empleando un catéter Simmons tipo I. Posicionamos la punta del catéter más allá de lostium de la vena espermática para realizar el venograma de la venarenal izquierda mediante la administración de contraste yodado, que fluirá de forma retrógrada hasta testes. La embolización se realizará através de la introducción de coils metálicos (aproximadamente de 6 a8) de 0.038 empleando un catéter hidrofílico de 4 o 5F.Del total de los 37 casos tratados, se consiguieron embolizar correctamente33 pacientes (89,2%), siendo necesario una reembolización entres casos (10,8%) de los que uno acabó en cirugía. Tan sólo en un caso(2,7%) se practicó cirugía por embolización incompleta (AU)
Varicocele consists of the varicose expansion of the spermatic vein. Its more frequently in the left side (10:1) as consequence of an evilfunctioning or absence of the valves of the spermatic left vein. Between March 1999 and December 2009 there have been gathered a total of 37cases diagnosed of varicocele in the pediatric population of our center. After a local anesthetic we created a femoral aproach. We advanceinto the left renal vein using a catheter Simmons type I and then we position the top of the catheter beyond the ostium of the spermatic veinto fulfil the renal left vein by means of the administration of contrastiodized and gonadal vein could be visualized using retrograde phlebography .Transcatheter embolization will carry out across the introduction of coils (approximately from 6 to 8) of 0.038 using a hidrofiliccatheter of 4 or 5F.Of the total of the 37 cases, we obtained correctly embolization in33 patients (89.2%), being necessary a reembolization in three cases(10.8%) of which one finished in surgery. Only in a case (2.7%) surgerywas practised for embolization incomplete (AU)
Subject(s)
Humans , Male , Child , Embolization, Therapeutic/methods , Varicocele/surgery , Blood Vessel Prosthesis , Anesthesia, Local , Retrospective StudiesABSTRACT
Varicocele consists of the varicose expansion of the spermatic vein. It's more frequently in the left side (10:1) as consequence of an evil functioning or absence of the valves of the spermatic left vein. Between March 1999 and December 2009 there have been gathered a total of 37 cases diagnosed of varicocele in the pediatric population of our center. After a local anesthetic we created a femoral aproach. We advance into the left renal vein using a catheter Simmons type I and then we position the top of the catheter beyond the ostium of the spermatic vein to fulfil the renal left vein by means of the administration of contrast iodized and gonadal vein could be visualized using retrograde phlebography. Transcatheter embolization will carry out across the introduction of coils (approximately from 6 to 8) of 0.038 using a hidrofilic catheter of 4 or 5F. Of the total of the 37 cases, we obtained correctly embolization in 33 patients (89.2%), being necessary a reembolization in three cases (10.8%) of which one finished in surgery. Only in a case (2.7%) surgery was practised for embolization incomplete.
