Preliminary study on ultrasound-guided high-intensity focused ultrasound ablation for treatment of broad ligament uterine fibroids

Figures & data

Table 1. The data of patients with broad ligament fibroids and ultrasound-guided HIFU treatment results.

Patient	Age	Location	volume	T2WI	Pattern of	NPV Ratio	Fibroids at 6m after treatment
No.	(y)	of myoma	(cm^3)	signal	blood supply	(%)	volume (cm^3)	reduction rate (%)
1	43	left	111.6	hypointense	hypovascular	63.6	65.1	−41.7
2	40	right	128.0	hypointense	moderately vascular	83.7	50.9	−60.2
		left	25.7	hypointense	hypovascular	92.3	9.7	−62.2
3	44	right	69.9	isointense	hypervascular	75.1	35.2	−49.7
4	36	right	57.8	isointense	moderately vascular	93.1	20.2	−65.1
5	37	left	69.2	hypointense	hypovascular	79.2	27.1	−60.8
6	43	left	53.1	hypointense	hypovascular	77.1	30.8	−42.0
7	42	left	121.8	hypointense	hypervascular	91.3	54.2	−55.5
8	43	right	69.1	hypointense	hypovascular	72.3	40.0	−42.1
9	39	right	81.3	hypointense	hypovascular	95.4	25.5	−68.7
10	46	right	28.8	hypointense	hypovascular	85.6	12.2	−57.6
11	32	left	152.1	isointense	hypovascular	85.6	59.6	−60.8
12	24	right	58.4	hypointense	moderately vascular	97.8	21.1	−63.8

Figure 1. Contrast enhanced-MRI images of a 36-year-old woman with a right broad ligament fibroid. These showed a moderately vascular fibroid before treatment (A) and more than 90% NPV ratio immediately after HIFU ablation (B).

Figure 2. A 42-year-old woman with a left broad ligament uterine fibroid and a small submucous fibroid. The fibroid was hypo-intense on T2WI MRI (A) and hypervascular on CE-MRI before treatment (B). There was localized edema and swelling of abdominal muscles (white arrow) (C) and the NPV ratio of the treated fibroid was 91.3% immediately after treatment (D). No abnormal MRI finding related to focused ultrasound ablation was observed (E) and the fibroid volume decreased by 55.5% at 6-month follow-up (F).

Table 2. The symptom changes at 6 months after treatment (n = 12).

Symptoms	Relief or dissipate	No improvement
Frequent urination (n = 4)	4	0
Low back pain (n = 5)	5	0
Constipation (n = 2)	2	0
Menorrhagia (n = 6)	5	1
Dysmenorrhea (n = 1)	1	0
Anemia (n = 3)	3	0
Low abdominal pain (n = 2)	2	0

Figure 3. A 24-year-old woman with a right broad ligament uterine fibroid. The CE-MRI showed a right broad ligament uterine fibroid oppressing the right iliac vessels (A) and the non-perfused area of ablated fibroid (97.8% of NPV ratio) with intact serosal layer after HIFU ablation (B).