Dataset Information

Volumetric MR-guided high-intensity focused ultrasound ablation to treat uterine fibroids through the abdominal scars using scar patch: a case report.

ABSTRACT: BACKGROUND:Abdominal scars pose a challenge in magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) therapies, limiting patient selection and increasing the risk of skin burns. Especially, scars arising from longitudinal incisions are problematic as they usually lie medially at the lower abdomen where the ultrasound beam has to go through. Volumetric sonication has been shown to efficiently enlarge the ablated volume per sonication, but they nevertheless require more thermal energy to be deposited per sonication which increases the temperature in the near-field area located between the transducer and the target region. CASE PRESENTATION:The scar patch was used in three patients undergoing MR-HIFU ablation of fibroids using volumetric technique, one with transverse incision and the other two with longitudinal incision. No severe adverse effects were observed. The relative shrinkage of the fibroid of these patients at 6-month follow-up were 67, 78, and 59 %, respectively. CONCLUSIONS:Our preliminary experience suggests that the use of scar patch on MR-HIFU ablation of fibroids using volumetric technique provides an effective treatment option for patients who were previously excluded from MR-HIFU treatment due to the abdominal scars.

SUBMITTER: Zhu Y

PROVIDER: S-EPMC4982143 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Volumetric MR-guided high-intensity focused ultrasound ablation to treat uterine fibroids through the abdominal scars using scar patch: a case report.

Zhu Ying Y Keserci Bilgin B Viitala Antti A Wei Juan J Yang Xuedong X Wang Xiaoying X

Journal of therapeutic ultrasound 20160811

<h4>Background</h4>Abdominal scars pose a challenge in magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) therapies, limiting patient selection and increasing the risk of skin burns. Especially, scars arising from longitudinal incisions are problematic as they usually lie medially at the lower abdomen where the ultrasound beam has to go through. Volumetric sonication has been shown to efficiently enlarge the ablated volume per sonication, but they nevertheless require more the ...[more]

PMID: 27525101

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Project description:BACKGROUND:Uterine leiomyomas are common benign tumours found in women of reproductive age that are rarely associated with intra-abdominal haemorrhage. The aetiology behind this relationship is poorly understood and the aforementioned association poorly recognized from a patient's clinical presentation. Available information in the literature is limited to case reports. The aim of this systematic review is to document and highlight the occurrence of intra-abdominal haemorrhage from uterine fibroids, and determine associated morbidity and mortality. METHODS:A systematic review of Medline, EMBASE, Web of Science, Scopus, and The Cochrane Library - CENTRAL was performed from the databases inception through to December 2018 for case report and series of patients who experienced intra-abdominal haemorrhage from uterine fibroids. Findings were presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS:We identified 115 publications reporting on 125 original case reports. The documented intra-abdominal haemorrhage were commonly due to the rupture of superficial blood vessels over the surface of a fibroid, followed by rupture and avulsion of the fibroid involved. A clinical picture of sudden and profound hypovolemic shock with severe abdominal pain was often the presenting complaint, with a correct pre-operative diagnosis only made in 7 cases on computed tomography imaging. Hysterectomy and myomectomy were the most common surgery performed. Mortality was reported in 4 cases which were directly related to complications of uterine fibroids. CONCLUSION:Intra-abdominal haemorrhage secondary to uterine fibroids remained a rare phenomenon which is poorly recognized among clinicians. While this association is not representative of the population of interest, it highlights the pathophysiological spectrum of uterine fibroids and its relevance to emergency physicians, surgeons and gynaecologists during clinical practice.

Dataset Information

Volumetric MR-guided high-intensity focused ultrasound ablation to treat uterine fibroids through the abdominal scars using scar patch: a case report.

Publications

Volumetric MR-guided high-intensity focused ultrasound ablation to treat uterine fibroids through the abdominal scars using scar patch: a case report.

Similar Datasets

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