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Objective To investigate the safety and efficacy of microwave ablation guided with laparoscopy and transvaginal ultrasound in the treatment of adenomyosis.Methods Seventy patients with 89 lesions of adenomyosis were treated with laparoscopy and transvaginal ultrasound guided microwave ablation.Intraoperative and postoperative complications were observed.The differences in dysmenorrhea score,menstrual flow and dysmenorrhea time before and after treatment were compared.Ultrasound examinations were performed 1,3 and 6 months after treatment to measure the volumes of uterus and adenomyosis lesions.Results Outflow liquid from vagina 1-3 days after treatment was found in 1 patient,and mild vaginal bleeding was found in 3 patients.No serious complication occurred in the other 66 patients.Compared with preoperation,the dysmenorrhea score,menstrual flow and dysmenorrhea time decreased in all patients after treatment (all P＜0.01).The volumes of uterus and adenomyosis lesions 1,3 and 6 months after treatment were significantly less than those before treatment (all P＜0.01).Conclusion Laparoscopy and transvaginal ultrasound guided microwave ablation is a safe and efficient therapy for adenomyosis.
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Purpose To explore the short-term clinical efficacy and application value of transvaginal sonography-guided laparoscopic percutaneous microwave coagulation therapy in the treatment of uterine adenomyoma.Materials and Methods Forty patients with uterine adenomyoma who visited the Central Hospital of Wuhan from October 2015 to October 2016 were selected in this study.These patients were invalid in traditional treatment for severe dysmenorrheal,but still unwilling to excise uterus.Microwave needles were placed into uterine adenomyoma to conduct percutaneous microwave coagulation therapy under the whole-process monitoring and guidance of laparoscope and transvaginal ultrasonography.Results All of 64 nidi in the 40 patients were ablated successfully,and none had damage to peripheral vital organs or vessels.Intraoperative hemorrhagic volume was extremely small.Postoperative menstrual blood volume and dysmenorrheal severity were improved notably,but none had obvious recurrence until now.The uterine volumes at postoperative one,three and six months as well as one year were (135.0±73.2) cm3,(108.2 ± 62.9) cm3,(91.4 ± 58.4) cm3,and (84.8 ± 50.0) cm3,respectively,all were evidently smaller than the (207.2± 97.4) cm3 before operation (P＜0.01).The n idus sizes at postoperative one,three and six months as well as one year were (42.3±34.2) cm3,(30.6±27.4) cm3,(24.7±23.0) cm3 and (23.0± 19.4) cm3,respectively,all were evidently smaller than the (67.9±48.2) cm3 before operation (P＜0.01).There were also significant differences in laboratory examinations of CA125 and CA199 before and after operation (P＜0.01).Conclusion Percutaneous microwave coagulation therapy as a non-invasive technique that can both maintain patients' uteruses and resolve their pain,is more safe and real-time under the monitoring of laparoscope,thus being promising as a new routine for the treatment of uterine adenomyoma.
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Objective To investigate the diagnostic value of parametric imaging of contrast-enhanced ultrasound (CEUS) in retroperitoneal tumors using SonoLiver software. Methods Sixty cases of retroperitoneal tumors were analyzed by CEUS with SonoLiver software. The color-mapped images of timedependent indexes, such as rise time(RT), time to peak(TTP), mean transit time(mTT), were abserved in the regions of interests(ROIS). The degree of the coincidence between pathologic diagnosis and parametric imaging diagnosis was carefully study by comparing parametric images with histopathological findings.Results 1 ) There was statistical significance of RT, TTP and mTT between the benign and malignant retroperitoneal tumors. 2) The time-dependent parametric images were obvious different between benign lesions and malignant lesions. The malignant lesions enjoyed a confused boundary and distribute disorderly,while the benign tumors had a clear distribution. There was a good coincidence degree between pathologic diagnosis and parametric imaging diagnosis(κ =0. 625, P =0. 000). Sensibility, specificity, the rate of misdiagnosis and missed diagnosis, the degree of accuracy respectively was 85.3 ％, 76.9 ％, 23.1 ％, 14.7 ％,81.7％ by the new diagnosis method. Conclusions Parametric imaging is a very useful way of evaluating the level of blood flow with the tumors and provides a new vision in the diagnosis of retroperitoneal tumors. It demonstrates retroperitoneal tumors clearly and objectively.