Ultrasound-guided percutaneous microwave ablation for adenomyosis: efficacy of treatment and effect on ovarian function

Yu Yang, Jing Zhang, Zhi-yu Han, Xia Ma, Yan-li Hao, Chang-tao Xu, Rui-fang Xu, Bing-song Zhang, Yu Yang, Jing Zhang, Zhi-yu Han, Xia Ma, Yan-li Hao, Chang-tao Xu, Rui-fang Xu, Bing-song Zhang

Abstract

A total of 142 premenopausal women with symptomatic adenomyosis underwent ultrasound (US)-guided percutaneous microwave ablation (PMWA) at the Chinese PLA General Hospital. This study aimed to evaluate changes in serum pituitary, gonadal hormone and cancer antigen 125 (CA125) levels after US-guided PMWA. Therefore, estradiol (E2), follicle-stimulating hormone (FSH), prolactin (PRL) and CA125 levels were evaluated before ablation and at 3, 6, 9 and 12 months after ablation. No significant differences were observed in the E2 and FSH levels pre-ablation and during follow-up (E2: p=0.933, p=0.987, p=0.106, p=0.936; FSH: p=0.552, p=0.295, p=0.414, p=0.760). The mean absolute values of serum CA125 and PRL were significantly decreased at 3, 6, 9 and 12 months after ablation (CA125: p<0.001, p<0.001, p<0.001, p=0.003; PRL: p<0.001, p<0.001, p<0.001, p<0.001). A significant correlation between changes in CA125 levels and uterine volume was found (p<0.001). No evidence of a decline in ovarian function was observed after US-guided PMWA.

Figures

Figure 1
Figure 1
The diagram of PMWA.
Figure 2
Figure 2
A 35-year-old woman with adenomyosis. Her uterus size was 9.3 cm*8.0 cm*8.7 cm. (a) MRI (T2WI): the enlargement of the junctional zone in the anterior wall. (b) CEUS before ablation: contrast agent perfused in the entire uterus. (c) The microwave energy radiated from the emission tip. (d) After the hyperechogenic signal covered at least 50% of the entire lesion, CEUS was performed to assess the volume of the non-perfused region. (e) Three days after PMWA, contrast-enhanced MRI was performed to evaluate both the efficacy of the ablation and the viability of the organs surrounding the uterus.

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