MR guided Focused Ultrasound Surgery (MRgFUS) of symptomatic
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Uterine leiomyomata or fibroids are common smooth muscle tumors affecting up to 60% of women by age 45 [1,2]. Fibroids can vary with regard to size and location and can result in a variety of symptoms including menorrhagia, pelvic pressure and pain, frequent urination, constipation, and infertility. Hysterectomy is considered definitive therapy but is not without complications, including pelvic floor or sexual dysfunction, and long-term urinary incontinence [3-5].

Uterine preserving treatments include myomectomy, radiofrequency ablation, uterine artery embolization and medical therapy. Myomectomy, which can be performed hysteroscopically, laparoscopically or via laparotomy, is less invasive than hysterectomy, but carries with it the costs and morbidity associated with surgery. Uterine artery embolization, while minimally invasive, has drawbacks of ionizing radiation and the potential risk of premature menopause secondary to nontarget embolization of the ovaries [6]. Medical therapy may not alleviate all of the fibroid symptoms and may be difficult to tolerate for some patients. Hormonal treatment, which aims to reduce fibroid vascularity, may result in osteoporosis and menopausal symptoms and are therefore not recommended for more than 6 months [7].

MR-guided focused ultrasound surgery (MRgFUS) is a novel therapy which offers patients a noninvasive procedure without the use of ionizing radiation and can be performed on an outpatient basis. As this technique becomes more widely integrated into clinical practice, it is important for radiologists to be familiar with its technique, the relevant MR imaging features of fibroids that are amenable to MRgFUS therapy and the expected imaging findings and complications after treatment.
Dr. H●●●●h D●●●i
Dr. H●●●●h D●●●i Obstetrics and Gynaecology
Fibroids are increasingly diagnosed from 3rd decades upwards. Uterine preserving modes of treatment are required before 40 years of age. Myomectomies- laproscopic or open are major surgeries with their inherent risks but major drawback is high chances of recurrence-new fibroids growing with age. Thus noninvasive, nonionising outdoor treatment will be great help to the patients. Cost factor & long term outcome should be checked.... Read more
Mar 17, 2017Like