Our Summary

This study researched the effectiveness of using a specific type of ultrasound, called contrast-enhanced ultrasonography (CEUS), in the treatment of a painful uterus condition called focal uterine adenomyosis. The treatment involved using microwave ablation (MWA), which is a type of heat therapy.

The researchers looked at 52 patients who had this condition and this treatment between March 2020 and January 2023. They used CEUS both before and after the treatment to look at the affected areas, and then compared these results with another type of imaging technique, called dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

The findings showed no significant differences between what the CEUS and DCE-MRI were able to see immediately after the treatment and in the months following. They also found that after 3 months, the size of both the uterus and the painful areas had reduced significantly in most cases. In particular, they found that if the CEUS showed areas that didn’t enhance (or “light up”) before treatment, this was linked to better outcomes.

After 12 months, there were significant decreases in both uterus and painful area sizes, and the patients’ painful periods and heavy bleeding had significantly improved. There were no major complications.

In conclusion, the study suggests that CEUS can effectively be used to assess the treatment of focal uterine adenomyosis with MWA, similarly to DCE-MRI. If the CEUS shows non-enhancing areas before treatment, this could indicate better treatment outcomes.

FAQs

  1. What is the role of contrast-enhanced ultrasonography (CEUS) in the treatment of focal uterine adenomyosis?
  2. How does microwave ablation (MWA) affect the size of the uterus and painful areas in patients with focal uterine adenomyosis?
  3. What does it mean if the CEUS shows non-enhancing areas before the treatment of focal uterine adenomyosis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about uterine ablation is to discuss the possibility of using contrast-enhanced ultrasonography (CEUS) to assess the effectiveness of the treatment. CEUS can provide valuable information about the affected areas before and after the procedure, helping to track progress and outcomes. It may also help predict treatment success based on the presence of non-enhancing areas. It’s important to have open communication with your healthcare provider about all available options for monitoring and optimizing your treatment for uterine conditions.

Suitable For

Patients who are typically recommended uterine ablation are those who suffer from heavy menstrual bleeding, painful periods, or other symptoms related to conditions such as uterine fibroids or adenomyosis. These patients may have tried other treatments that have not been effective or are looking for a minimally invasive option. Uterine ablation is often recommended for patients who do not want to or cannot undergo a hysterectomy.

Timeline

Before uterine ablation:

  • Patient experiences symptoms of painful periods, heavy bleeding, and possibly infertility
  • Patient undergoes diagnostic tests such as ultrasounds or MRIs to determine the cause of their symptoms
  • Diagnosis of focal uterine adenomyosis is made
  • Patient and healthcare provider discuss treatment options, including uterine ablation

After uterine ablation:

  • Patient undergoes uterine ablation procedure, such as microwave ablation
  • CEUS is used to assess the affected areas immediately after the treatment
  • CEUS findings are compared to DCE-MRI results
  • Size of uterus and painful areas reduce significantly after 3 months
  • Patient experiences improvements in symptoms such as painful periods and heavy bleeding after 12 months
  • CEUS can effectively assess treatment outcomes and potentially predict better outcomes if non-enhancing areas are observed before treatment

What to Ask Your Doctor

  1. What is uterine ablation and how does it work?
  2. Am I a suitable candidate for uterine ablation?
  3. What are the potential risks and side effects of uterine ablation?
  4. How effective is uterine ablation in treating my specific condition?
  5. How long does it take to see results following uterine ablation?
  6. Will I still be able to get pregnant after undergoing uterine ablation?
  7. Are there any lifestyle changes or precautions I need to take after the procedure?
  8. How often will I need follow-up appointments after uterine ablation?
  9. Are there any alternative treatments to consider for my condition?
  10. Can you explain the imaging techniques used to monitor the effectiveness of uterine ablation, such as CEUS and DCE-MRI?

Reference

Authors: Li XL, Li JX, Yu SY, Fan PL, Jin YJ, Xu EJ, Guan SN, Deng EY, Li QY, Ji ZB, Qi JL, Xu HX; China Alliance of Multi-Center Clinical Study for Ultrasound (Ultra-Chance). Journal: Ultrasonography. 2024 Jan;43(1):68-77. doi: 10.14366/usg.23145. Epub 2023 Nov 7. PMID: 38109892