Post treatment and 3 month contrast enhanced MRI findings following HIFU of submucosal fibroids: a retrospective study

Abstract

Purpose This study used contrast-enhanced MRI (CE-MRI) examination to assess the efficacy of high-intensity focused ultrasound (HIFU) for submucosal fibroids. Methods A total of 81 submucosal fibroids, including 33 cases of type 1, 29 cases of type 2, and 19 cases of type 2–5, treated by HIFU were retrospectively reviewed. CE-MRI was performed in all cases immediately after HIFU, the non-perfused volume ratio (NPVR) and the degree of endometrial impairment were recorded. Thereafter, CE-MRI was repeated in all cases after three months, and the change of fibroid volume shrinkage rate (FVSR), NPVR and the degree of endometrial impairment were recorded. Results The immediate NPVR was 86.4 ± 19.3% in type 1, 90.0 ± 13.3% in type 2 and 90.3 ± 7.2% in type 2–5. Among 81 fibroids, grades 0, 1, 2 and 3 endometrial impairments were observed in 38.3%, 16.1%, 14.8% and 30.9%, respectively. Three months later, NPVR was 68.0 ± 36.4% in type 1, 74.3 ± 27.7% in type 2 and 85.0 ± 16.1% in type 2–5. Grades 0, 1, 2 and 3 endometrial impairments were observed in 64.2%, 23.5%, 9.9% and 2.4%.FVSR was 49.0 ± 1.3% in type 1, 39.6 ± 1.7% in type 2 and 37.2 ± 2.1% in type 2–5. The FVSR in submucosal fibroid type 1 was superior to type 2 and type 2–5 (p < 0.05). The NPVR of submucosal fibroids in type 2–5 were higher than type 1 (p < 0.05) .There was no difference among different types of submucosal fibroids in endometrial impairment (p > 0.05) three months after HIFU. Conclusions At three months after HIFU, FVSR was better for submucosal fibroid type 1 than for type 2 and type 2–5. And there was no difference in endometrial impairment among the different types of submucosal fibroid groups.