HIFU-ABLATION – LONG-TERM  TREATMENT  RESULTS  OF  THE  UTERINE FIBROIDS

Berlim Yu.D., Dombrovskiy V.I., Isaev A.Yu., Mineev N.I., Voloshin V.V., Paleniy A.I.

 

Rostov State Medical University. Rostov-on-Don, Russia.

Purpose. In the literature there are few papers devoted to the description of the physical principles, the process of implementation and the clinical results of the application of uterine fibroids ablation using high intensity focused ultrasound (HIFU), so-called HIFU-ablation guided by magnetic resonance imaging (MRI). Radiologist is the main performer of this manipulation. Therefore, it seems appropriate to acquaint the radiologists with the basis of this hybrid technology, its advantages and limitations by the example of a clinical case.

Materials and methods. The results of combined treatment of a young woman for multiple uterine fibroids of different histological structure were presented in this study. The radiological diagnostic methods for the detection and identification of this benign tumor, as well as for monitoring the health status of the patient at different stages of medical care were applied. The final diagnosis was based on the pathomorphologic findings of surgical material received after conservative myomectomy. HIFU-ablation was carried out on "ExAblate 2000" unit ("InSightec Ltd.", Haifa, Israel) integrated within MRI scanner "Signa HDxt 1.5" ("GEHC", Milwaukee, WI, USA).

Results. We had to use HIFU-ablation of uterine fibroids in this study due to unrealized reproductive function in the young patient and her flat refusal from surgical intervention. The volumetric indices of thermal damage of two myomatous nodules tissue (63 % and 72 %) suggested the possibility of achieving the desired result, which was demonstrated by the prolonged absence of clinical manifestation of the disease within 4.5 years.

Conclusions. HIFU-ablation is an effective method of treating for this disease. It has undeniable advantages, however, it requires further consideration of the indications for using and improvement of the standard base.

Keywords: uterine fibroid, magnetic resonance imaging, high intensity focused ultrasound (HIFU) ablation.

Corresponding author:   Dombrovskiy V.I. Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Berlim Yu.D., Dombrovskiy V.I., Isaev A.Yu., Mineev N.I., Voloshin V.V., Paleniy A.I. HIFU-ablation – long-term treatment results of the uterine fibroids. REJR. 2016; 6 (1): 91-106. doi: 10.18411/a-2016-011.