Treatment of Uterine Fibroids by Using Magnetic Resonance-guided Focused Ultrasound Ablation: The Initial Experience in Taiwan

以磁振導航超音波手術治療子宮肌瘤：臺灣之初期經驗

林逸襄(Yi-Hsiang Lin) ； 梁庭繼(Ting-Kai Leung) ； 王鴻蓉(Hung-Jung Wang) ； 孔慶惠(Ching-Huei Kung) ； 蕭涵勻(Han-Yun Hsiao) ； 丁鈺靜(Yu-Ching Ting) ； 陳雅妍(Ya-Yen Chen) ； 李志明(Chi-Ming Lee)

《中華放射線醫學雜誌》 34卷4期 (2009/12) Pp. 263-271

摘要

子宮肌瘤是婦女常見之良性腫瘤，以往大部分的治療方法是使用手術治療。磁振導航超音波手術是過去幾年來用來治療子宮肌瘤之新方法，主要是以高能聚焦超音波將能量聚焦於病變組織，使組織造成凝固性壞死。本文報告三位罹患子宮肌瘤之婦女，在接受磁振導航超音波手術治療3個月後，其肌瘤體積變化及症狀嚴重度之改善情形。
本研究募集三位罹患子宮肌瘤之婦女，平均年齡為38.3歲。在治療前以磁振造影來評估子宮肌瘤之體積，並以Uterine Fibroid Symptoms and Quality and Life Questionnaire(UFSQOL)問卷來計算其症狀嚴重度分數。在治療3個月後，同樣再測量一次肌瘤之體積，並再做一次問卷以計算症狀嚴重度分數，以評估磁振導航超音波手術對於子宮肌瘤之治療效果。
結果顯示，三位病患在接受治療後，皆無嚴重副作用之發生。在進行治療3個月後，三位病患之平均肌瘤體積下降30.8%，而平均症狀嚴重度分數則下降30.6%。
以磁振導航超音波手術來治療子宮肌瘤是一安全且有效之治療方法。本研究也建議一個較長期且較多病患數之研究是必要的。

並列摘要

Uterine leiomyomas (fibroids) are the most common benign neoplasm in women of childbearing age. Magnetic resonance-guided focused ultrasound ablation (MRgFUS) has been used worldwide to treat symptomatic uterine fibroids over the past few years. This paper describes our experiences with three patients that were treated with MRgFUS for uterine fibroids and their follow-up status after 3 months.
Three patients with uterine fibroids underwent MRgFUS on February, 2009. Before the treatment and at 3 months post-treatment, we used the Uterine Fibroid Symptoms and Quality of Life Questionnaire (UFS-QOL) to determine symptom severity scores (SSS). We also evaluate the change in fibroid volume after 3 months using T1-weighted contrast enhanced MRI images.
No serious or unexpected adverse events arose during the study. All patients were followed up for 3 months. The fibroid volume reduction after 3 months was 30.8% in average, and SSS reduction after 3 months was 30.6%.
Our results demonstrate that MRgFUS can safely and effectively ablate uterine fibroids to produce a significant decrease in mean fibroid volume and improvement in SSS for up to 3 months post-treatment.