留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码
x

超声引导下射频消融治疗子宫肌瘤的临床应用进展

吴巧至,  郭遂群

downloadPDF
文章导航 > 分子影像学杂志  > 2023 >  46(2): 375-380
吴巧至, 郭遂群. 超声引导下射频消融治疗子宫肌瘤的临床应用进展[J]. 分子影像学杂志, 2023, 46(2): 375-380. doi: 10.12122/j.issn.1674-4500.2023.02.36
引用本文: 吴巧至, 郭遂群. 超声引导下射频消融治疗子宫肌瘤的临床应用进展[J]. 分子影像学杂志, 2023, 46(2): 375-380. doi: 10.12122/j.issn.1674-4500.2023.02.36
shu
WU Qiaozhi, GUO Suiqun. Clinical application and progress of ultrasound-guided radiofrequency ablation in the treatment of uterine fibroids[J]. Journal of Molecular Imaging, 2023, 46(2): 375-380. doi: 10.12122/j.issn.1674-4500.2023.02.36
Citation: WU Qiaozhi, GUO Suiqun. Clinical application and progress of ultrasound-guided radiofrequency ablation in the treatment of uterine fibroids[J]. Journal of Molecular Imaging, 2023, 46(2): 375-380. doi: 10.12122/j.issn.1674-4500.2023.02.36
shu

超声引导下射频消融治疗子宫肌瘤的临床应用进展

doi: 10.12122/j.issn.1674-4500.2023.02.36

  • 南方医科大学附属第三医院妇产科，广东 广州 510630

详细信息
    作者简介:

    吴巧至，在读硕士研究生，E-mail: 2724691073@qq.com

    通讯作者:

    郭遂群，主任医师，教授，博士生导师，E-mail: guosq2006@126.com

Clinical application and progress of ultrasound-guided radiofrequency ablation in the treatment of uterine fibroids

  • Department of Obstetrics and Gynecology, the Third Affiliated Hospital, Southern Medical University, Guangzhou 510630, China

    摘要
  • 摘要: 目子宫肌瘤是女性生殖器最常见的良性肿瘤，多发于30~50岁的育龄妇女。子宫肌瘤的传统治疗方法是手术切除，包括子宫切除术和肌瘤剔除术，但手术创伤大、恢复期长。随着微创医疗技术的发展和女性认知的提高，越来越多的子宫肌瘤患者选择疗效好且保留子宫的微创治疗方法。射频消融是常用的治疗子宫肌瘤的微创方法，其安全性和有效性已被临床证实，术后患者症状改善，生活质量提高，复发率低。本文依据穿刺路径和超声引导方式不同分将其归纳为经腹部超声引导、腹腔镜术中超声引导、经阴道超声引导和经宫颈宫腔内超声引导4种射频消融方式，并从原理、方法、消融途径、有效性、安全性及对生育功能影响等方面对4种子宫肌瘤消融方法进行简要综述。

     

    Abstract: Uterine fibroids are the most common benign tumors of female genitalia, most of which occurred in of 30 to 50 years old childbearing-aged women. The traditional treatment of uterine fibroids is surgical resection, including hysterectomy and myomectomy. However, the surgical trauma is severe and costs a long term of recovery. With the development of minimally invasive medical technology and the improvement of women's cognition, more and more patients diagnosed with uterine fibroids choose to receive minimally invasive treatment with the hope of better curative effect and the preservation of fertility. Radiofrequency ablation is one of the most commonly used minimally invasive methods for the treatments of uterine fibroids which safety and effectiveness has been clinically proven. After operation, the symptoms of patients are relieved, the life quality is improved, and the tumor recurrence rate is low. In this paper, radiofrequency ablation methods of Uterine fibroids are classified into four methods by both puncture paths and ultrasound-guided methods: transabdominal ultrasound-guided, laparoscopic ultrasound-guided, transvaginal ultrasound-guided and transcervical ultrasound-guided. In addition, these four methods are briefly reviewed from principle, method, ablation path, effectiveness, safety and influence on fertility ability.

     

    • HTML全文
    • 参考文献(58)
  • [1] Duhan N. Current and emerging treatments for uterine myoma-an update[J]. Int J Women's Health, 2011, 3: 231-41.
    [2] Coyne KS, Harrington A, Currie BM, et al. Psychometric validation of the 1-month recall Uterine Fibroid Symptom and Health-Related Quality of Life questionnaire (UFS-QOL)[J]. J Patient Rep Outcomes, 2019, 3(1): 57. doi: 10.1186/s41687-019-0146-x
    [3] Wise LA, Laughlin-Tommaso SK. Epidemiology of uterine fibroids: from menarche to menopause[J]. Clin Obstet Gynecol, 2016, 59(1): 2-24. doi: 10.1097/GRF.0000000000000164
    [4] Veronica M, Ali A, Venkateshwari A, et al. Association of estrogen and progesterone receptor gene polymorphisms and their respective hormones in uterine leiomyomas[J]. Tumor Biol, 2016, 37(6): 8067-74. doi: 10.1007/s13277-015-4711-5
    [5] Tinelli A, Sparic R, Kadija S, et al. Myomas: anatomy and related issues[J]. Minerva Ginecol, 2016, 68(3): 261-73.
    [6] Spies JB, Coyne K, Guaou Guaou N, et al. The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata[J]. Obstet Gynecol, 2002, 99(2): 290-300.
    [7] Havryliuk Y, Setton R, Carlow JJ, et al. Symptomatic fibroid management: systematic review of the literature[J]. JSLS, 2017, 21(3): e2017.00041. doi: 10.4293/JSLS.2017.00041
    [8] Zepiridis LI, Grimbizis GF, Tarlatzis BC. Infertility and uterine fibroids[J]. Best Pract Res Clin Obstet Gynaecol, 2016, 34: 66-73. doi: 10.1016/j.bpobgyn.2015.12.001
    [9] Guo XC, Segars JH. The impact and management of fibroids for fertility: an evidence-based approach[J]. Obstet Gynecol Clin North Am, 2012, 39(4): 521-33. doi: 10.1016/j.ogc.2012.09.005
    [10] Jacoby VL, Autry A, Jacobson G, et al. Nationwide use of laparoscopic hysterectomy compared with abdominal and vaginal approaches[J]. Obstet Gynecol, 2009, 114(5): 1041-8. doi: 10.1097/AOG.0b013e3181b9d222
    [11] Sesti F, Alonzo F, Ruggeri V, et al. A comparison of vaginal, laparoscopic-assisted vaginal, and minilaparotomy hysterectomies for enlarged myomatous uteri[J]. Int J Gynecol Obstet, 2008, 103(3): 227-31. doi: 10.1016/j.ijgo.2008.07.006
    [12] Sinha R, Hegde A, Mahajan C, et al. Laparoscopic myomectomy: do size, number, and location of the myomas form limiting factors for laparoscopic myomectomy?[J]. J Minim Invasive Gynecol, 2008, 15(3): 292-300. doi: 10.1016/j.jmig.2008.01.009
    [13] Krzyzanowski J, Wozniak S, Szkodziak P, et al. Minimally invasive treatment options for uterine fibroids-state-of-the art 2021[J]. Ginekol Pol, 2022, 93(3): 242-7. doi: 10.5603/GP.a2021.0202
    [14] Chen HT, Athreya S. Systematic review of uterine artery embolisation practice guidelines: are all the guidelines on the same page?[J]. Clin Radiol, 2018, 73(5): 507. e9-507. e15. doi: 10.1016/j.crad.2017.12.005
    [15] Ghanaati H, Sanaati M, Shakiba M, et al. Pregnancy and its outcomes in patients after uterine fibroid embolization: a systematic review and meta-analysis[J]. Cardiovasc Intervent Radiol, 2020, 43(8): 1122-33. doi: 10.1007/s00270-020-02521-6
    [16] Kröncke T, David M. MR-guided focused ultrasound in fibroid treatment-results of the 4th radiological-gynecological expert meeting[J]. Geburtshilfe Frauenheilkd, 2019, 79(7): 693-6. doi: 10.1055/a-0893-4752
    [17] Bai XM, Cui M, Yang W, et al. The 10-year survival analysis of radiofrequency ablation for solitary hepatocellular carcinoma 5 cm or smaller: primary versus recurrent HCC[J]. Radiology, 2021, 300(2): 458-69. doi: 10.1148/radiol.2021200153
    [18] Dai JC, Morgan TN, Moody D, et al. Radiofrequency ablation of small renal masses[J]. J Endourol, 2021, 35(S2): S-38. doi: 10.1089/end.2020.1041
    [19] Chan MV, Huo YR, Cao C, et al. Survival outcomes for surgical resection versus CT-guided percutaneous ablation for stage I non-small cell lung cancer (NSCLC): a systematic review and meta-analysis[J]. Eur Radiol, 2021, 31(7): 5421-33. doi: 10.1007/s00330-020-07634-7
    [20] Ha EJ, Baek JH, Che Y, et al. Radiofrequency ablation of benign thyroid nodules: recommendations from the Asian conference on tumor ablation task force-secondary publication[J]. J Med Ultrasound, 2021, 29(2): 77-83. doi: 10.4103/JMU.JMU_178_20
    [21] Polin M, Hur HC. Radiofrequency ablation of uterine myomas and pregnancy outcomes: an updated review of the literature[J]. J Minim Invasive Gynecol, 2022, 29(6): 709-15. doi: 10.1016/j.jmig.2022.01.015
    [22] Lee BB, Yu SP. Radiofrequency ablation of uterine fibroids: a review[J]. Curr Obstet Gynecol Rep, 2016, 5(4): 318-24. doi: 10.1007/s13669-016-0183-x
    [23] Lim KJ, Yoon DY, Kim JH, et al. Percutaneous radiofrequency ablation for symptomatic uterine leiomyomas: a systematic review and meta-analysis[J]. Clin Exp Obstet Gynecol, 2016, 43(5): 643-9. doi: 10.12891/ceog3294.2016
    [24] Jones S, O'Donovan P, Toub D. Radiofrequency ablation for treatment of symptomatic uterine fibroids[J]. Obstet Gynecol Int, 2012, 2012: 194839.
    [25] Quinn SD, Gedroyc WM. Thermal ablative treatment of uterine fibroids[J]. Int J Hyperth, 2015, 31(3): 272-9. doi: 10.3109/02656736.2015.1010608
    [26] Torkzaban M, Machado P, Gupta I, et al. Contrast-enhanced ultrasound for monitoring non-surgical treatments of uterine fibroids: a systematic review[J]. Ultrasound Med Biol, 2021, 47(1): 3-18. doi: 10.1016/j.ultrasmedbio.2020.09.016
    [27] Lee BB. Radiofrequency ablation of uterine leiomyomata[J]. Obstet Gynecol, 2002, 99(Supplement): 9S.
    [28] Lee BB. Three-year follow-up post radiofrequency ablation of uterine leiomyomata[J]. J Min Inv Gynecol, 2005, 12(5): S51.
    [29] Carrafiello G, Recaldini C, Fontana F, et al. Ultrasound-guided radiofrequency thermal ablation of uterine fibroids: medium-term follow-up[J]. Cardiovasc Intervent Radiol, 2010, 33(1): 113-9. doi: 10.1007/s00270-009-9707-3
    [30] Yüce G, Tayarer A, Keskin HL, et al. Ultrasound guided percutaneous radiofrequency thermal ablation of symptomatic uterine fibroids-results from a single center and 52 weeks of follow up[J]. Ginekol Pol, 2020, 91(8): 447-52. doi: 10.5603/GP.2020.0074
    [31] Iversen H, Lenz S, Dueholm M. Ultrasound-guided radiofrequency ablation of symptomatic uterine fibroids: short-term evaluation of effect of treatment on quality of life and symptom severity[J]. Ultrasound Obstet Gynecol, 2012, 40(4): 445-51. doi: 10.1002/uog.11118
    [32] Chen JY, Chen WZ, Zhang L, et al. Safety of ultrasound-guided ultrasound ablation for uterine fibroids and adenomyosis: a review of 9988 cases[J]. Ultrason Sonochemistry, 2015, 27: 671-6. doi: 10.1016/j.ultsonch.2015.05.031
    [33] Bergamini V, Ghezzi F, Cromi A, et al. Laparoscopic radiofrequency thermal ablation: a new approach to symptomatic uterine myomas[J]. Am J Obstet Gynecol, 2005, 192(3): 768-73. doi: 10.1016/j.ajog.2004.10.591
    [34] Gerardo J, Leal G, MD, et al. Laparoscopic ultrasound-guided radiofrequency volumetric thermal ablation of symptomatic uterine leiomyomas: feasibility study using the halt 2000 ablation system[J]. J Minim Invasive Gynecol, 2011, 18(3): 364-71. doi: 10.1016/j.jmig.2011.02.006
    [35] Yu S, Silverberg K, Bhagavath B, et al. Post-market safety of laparoscopic ultrasound-guided radiofrequency ablation[J]. JSLS, 2020, 24(4): e2020.00050. doi: 10.4293/JSLS.2020.00050
    [36] Galen DI, Pemueller RR, Leal JGG, et al. Laparoscopic radiofrequency fibroid ablation: phase Ⅱ and phase Ⅲ results[J]. JSLS, 2014, 18(2): 182-90. doi: 10.4293/108680813X13693422518353
    [37] Kim CH, Kim SR, Lee HA, et al. Transvaginal ultrasound-guided radiofrequency myolysis for uterine myomas[J]. Hum Reprod, 2011, 26(3): 559-63. doi: 10.1093/humrep/deq366
    [38] Cho HH, Kim MR, Kim JH. Outpatient multimodality management of large submucosal myomas using transvaginal radiofrequency myolysis[J]. J Minim Invasive Gynecol, 2014, 21(6): 1049-54. doi: 10.1016/j.jmig.2014.04.019
    [39] Turtulici G, Orlandi D, Dedone G, et al. Ultrasound-guided transvaginal radiofrequency ablation of uterine fibroids assisted by virtual needle tracking system: a preliminary study[J]. Int J Hyperth, 2018, 35(1): 97-104. doi: 10.1080/02656736.2018.1479778
    [40] Rey VE, Labrador R, Falcon M, et al. Transvaginal radiofrequency ablation of myomas: technique, outcomes, and complications[J]. J Laparoendosc Adv Surg Tech A, 2019, 29(1): 24-8. doi: 10.1089/lap.2018.0293
    [41] Munro MG, Critchley HOD, Fraser IS, et al. The FIGO classification of causes of abnormal uterine bleeding in the reproductive years[J]. Fertil Steril, 2011, 95(7): 2204-8, 2208. e1-3. doi: 10.1016/j.fertnstert.2011.03.079
    [42] Brölmann H, Bongers M, Garza-Leal JG, et al. The FAST-EU trial: 12-month clinical outcomes of women after intrauterine sonography-guided transcervical radiofrequency ablation of uterine fibroids[J]. Gynecol Surg, 2016, 13(1): 27-35. doi: 10.1007/s10397-015-0915-3
    [43] Hudgens J, Johns DA, Lukes AS, et al. 12-month outcomes of the US patient cohort in the SONATA pivotal IDE trial of transcervical ablation of uterine fibroids[J]. Int J Womens Health, 2019, 11: 387-94. doi: 10.2147/IJWH.S201912
    [44] Chudnoff S, Guido R, Roy K, et al. Ultrasound-guided transcervical ablation of uterine leiomyomas[J]. Obstet Gynecol, 2019, 133(1): 13-22. doi: 10.1097/AOG.0000000000003032
    [45] Arnreiter C, Oppelt P. A systematic review of the treatment of uterine myomas using transcervical ultrasound-guided radiofrequency ablation with the Sonata system[J]. J Minim Invasive Gynecol, 2021, 28(8): 1462-9. doi: 10.1016/j.jmig.2021.04.009
    [46] Donald I, Galen, MD, et al. Does menstrual bleeding decrease after ablation of intramural myomas? A retrospective study[J]. J Minim Invasive Gynecol, 2013, 20(6): 830-5. doi: 10.1016/j.jmig.2013.05.007
    [47] Iversen H, Dueholm M. Radiofrequency thermal ablation for uterine myomas: long-term clinical outcomes and reinterventions[J]. J Minim Invasive Gynecol, 2017, 24(6): 1020-8. doi: 10.1016/j.jmig.2017.05.021
    [48] Robles R, Aguirre VA, Argueta AI, et al. Laparoscopic radiofrequency volumetric thermal ablation of uterine myomas with 12 months of follow-up[J]. Int J Gynaecol Obstet, 2013, 120(1): 65-9. doi: 10.1016/j.ijgo.2012.07.023
    [49] Jacoby VL, Parvataneni R, Oberman E, et al. Laparoscopic radiofrequency ablation of uterine leiomyomas: clinical outcomes during early adoption into surgical practice[J]. J Minim Invasive Gynecol, 2020, 27(4): 915-25. doi: 10.1016/j.jmig.2019.07.025
    [50] Jay M, Berman, MD, et al. Three-year outcome of the halt trial: a prospective analysis of radiofrequency volumetric thermal ablation of myomas[J]. J Minim Invasive Gynecol, 2014, 21(5): 767-74. doi: 10.1016/j.jmig.2014.02.015
    [51] Hahn M, Brucker S, Kraemer D, et al. Radiofrequency volumetric thermal ablation of fibroids and laparoscopic myomectomy: long-term follow-up from a randomized trial[J]. Geburtshilfe Frauenheilkd, 2015, 75(5): 442-9. doi: 10.1055/s-0035-1545931
    [52] Ángel SH, Mariña NF, Rebeca BV, et al. Efficacy, complications, and factors predictive of response to treatment with transvaginal radiofrequency ablation for symptomatic uterine myomas[J]. J Minim Invasive Gynecol, 2022, 29(6): 743-52. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXYD202202005.htm
    [53] Lukes A, Green MA. Three-year results of the SONATA pivotal trial of transcervical fibroid ablation for symptomatic uterine myomata[J]. J Gynecol Surg, 2020, 36(5): 228-33. doi: 10.1089/gyn.2020.0021
    [54] Garza-Leal JG. Long-term clinical outcomes of transcervical radiofrequency ablation of uterine fibroids: the VITALITY study[J]. J Gynecol Surg, 2019, 35(1): 19-23. doi: 10.1089/gyn.2018.0051
    [55] Yin GP, Chen M, Yang SJ, et al. Treatment of uterine myomas by radiofrequency thermal ablation: a 10-year retrospective cohort study[J]. Reprod Sci, 2015, 22(5): 609-14. doi: 10.1177/1933719114556481
    [56] Jeong HJ, Kwon BS, Choi YJ, et al. Rectouterine fistula after laparoscopic ultrasound-guided radiofrequency ablation of a uterine fibroid[J]. Obstet Gynecol Sci, 2014, 57(6): 553-6. doi: 10.5468/ogs.2014.57.6.553
    [57] Iversen H, Dueholm M. Radiofrequency thermal ablation for uterine myomas: long-term clinical outcomes and reinterventions[J]. J Minim Invasive Gynecol, 2017, 24(6): 1020-8. doi: 10.1016/j.jmig.2017.05.021
    [58] Jiang X, Thapa A, Lu J, et al. Ultrasound-guided transvaginal radiofrequency myolysis for symptomatic uterine myomas[J]. Eur J Obstet Gynecol Reproductive Biol, 2014, 177: 38-43. doi: 10.1016/j.ejogrb.2014.03.017
    • 相关文章
    • 施引文献
  • 资源附件(0)
  • 加载中
WeChat 点击查看大图
计量
  • 文章访问数:  313
  • HTML全文浏览量:  144
  • PDF下载量:  32
  • 被引次数: 0
出版历程
  • 收稿日期:  2022-12-16
  • 网络出版日期:  2023-04-28
  • 刊出日期:  2023-03-20

目录

    /

    返回文章
    返回
    • 版权所有© 2013《分子影像学杂志》编辑部 ICP备00000000号
    • 重点提示: Adobe Reader6可能造成全文显示不正常，请升级为Adobe Reader7或更高。
    • 地址: 广东省广州市广州大道北1838号 Tel: 020-61648176 E-mail: 

    本系统由 北京仁和汇智信息技术有限公司 开发  技术支持：info@rhhz.net

    x 关闭 永久关闭

    关于《分子影像学杂志》变更刊期通知

    各位专家、作者、读者：

    为了缩短出版时滞，促进科研成果的快速传播，我刊自2024年1月起，刊期由双月刊变更为月刊。本刊主要栏目有：基础研究、临床研究、技术方法、综述等。

    感谢各位专家、作者、读者长期以来对我刊的支持与厚爱！

    南方医科大学学报编辑部

    《分子影像学杂志》

    2023年12月27日