Assessing the Efficacy of High-Intensity Focused Ultrasound for Uterine Fibroids Using Dynamic Contrast-Enhanced-Magnetic Resonance Imaging.
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OBJECTIVE: To evaluate the efficacy of high-intensity focused ultrasound (HIFU) the treatment of uterine fibroids using dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI). STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Radiology, Liuzhou Hospital of Guangzhou Women and Children's Medical Centre, Liuzhou, China, from November 2019 to November 2022. METHODOLOGY: A total of 52 patients with 66 uterine fibroids were selected using random sampling to test treatment differences. The treatment effect was evaluated by analysing preoperative and postoperative T1WI, T2WI, and T1WI contrast-enhanced scans, comparing fibroid size, signal changes, and the degree of enhancement before and after treatment. The signal intensity ratio (SIR) was analysed using the Wilcoxon and paired t-test, while the non-perfused volume ratio (NPVR) was assessed using the Shapiro-Wilk test and the Kruskal-Wallis test. RESULTS: The NPVR of the low-enhancement group was 35.99 cm3, the equal-enhancement group was 82.87 cm3, and the high-enhancement group was 96.00 cm3. The NPVR values for the low-, equal-, and high-enhancement were 86.19, 78.17, and 64.60, respectively. The NPVR was significantly higher in the low-enhancement group than in the other two groups, with a significant difference of p <0.05. The postoperative NPVR was significantly correlated with varying degrees of enhancement (p <0.05). The NPVR was the highest in the low-enhancement group (86.19%), followed by the equal-enhancement group (78.17%), and the lowest in the high-enhancement group (64.60%). CONCLUSION: DCE-MRI plays a crucial role in assessing HIFU treatment efficacy for uterine fibroids. The degree of enhancement in uterine fibroids inversely correlates with ablation effectiveness, and DCE-MRI, utilising a high-concentration gadolinium-based contrast agent, provides a clearer depiction of the enhancement features of these fibroids. KEY WORDS: Uterine fibroids, Dynamic contrast-enhanced-MRI, High-intensity focused ultrasound, Non-perfused volume ratio.