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PubMed2006

Laparoscopic myomectomy for large uterine fibroids. A comparative study.

BACKGROUND: The goal of this study was to examine the safety and feasibility of laparoscopic myomectomy (LM) for the management of symptomatic intramural uterine fibroids with weight greater than 80 g as compared to those less than 80 g. METHODS: In a prospective comparative study, 176 women with symptomatic uterine fibroids were scheduled for LM. They were divided into two groups, one with main uterine fibroid (intramural type) weight greater than 80 g and the other with fibroid weight less than 80 g. Outcome measures for the two groups were studied in terms of operation time, amount of blood loss, requirement of blood transfusion, and length of hospital stay. RESULT: Operation time and amount of blood loss were significantly greater in the group with fibroid > or = 80 g than in the group < 80 g (121.5 +/- 58.9 min versus 79.1 +/- 28.6 min, p < 0.001; and 346.3 +/- 299.6 ml versus 123.0 +/- 89.7 ml, p < 0.001, respectively). However, there was no difference in the length of hospital stay and overall incidence of operative complications between these two groups. None of the women had any major complications. Nevertheless, 11 minor complications were noted, including two pelvic abscesses requiring a second laparoscopic treatment. There was no incidence of switching to laparatomy during the operation. Extreme intraoperative hemorrhage of more than 1000 ml occurred in 8 patients; however, all progressed to full recovery after blood transfusion. Rate of blood transfusion was significantly lower in the group with fibroid < 80 g (3.2% versus 22.1%, p < 0.001). CONCLUSIONS: Despite the increased operation time and blood loss, LM can be safely performed in the treatment of large uterine fibroid. However, high risk of blood transfusion in these patients has to be kept in mind.

Abscess↗
PubMed1988

Physicochemical characterization and functional activity of fibroid prolactin produced in cell culture.

Evidence from our laboratory with the use of cultured (primary and passaged) cells has extended our initial observation that human uterine fibroid is an extrapituitary source of prolactin. Fibroid prolactin antigen in conditioned medium reacted specifically in radioimmunoassay for human pituitary prolactin. Control experiments demonstrated that the radioimmunoassay results were not spurious due to degradation of tracer 125I-labeled prolactin. Immunoparallel dilution curves indicated antigenic relatedness of pituitary and fibroid prolactin. In a calibrated Sephadex G-100 column, fibroid prolactin eluted in the same region (20.3 to 20.9 kd) as purified pituitary prolactin. Glycosylated prolactin, detected by concanavalin A affinity column chromatography, appeared to constitute only a small percentage of fibroid prolactin made in culture. The ratio of fibroid prolactin bioactivity (lactogen Nb2 lymphoma bioassay) to antigen (radioimmunoassay) was 0.77. These data indicate that human uterine fibroid tissue produces a molecule similar to or, perhaps, identical with pituitary prolactin.

Cells, Cultured↗
PubMed2006

Risk factors for clinically diagnosed uterine fibroids in women around menopause.

OBJECTIVE: We analysed the risk factors for clinically diagnosed uterine fibroids in women attending menopause clinics in Italy. METHODS: Between 1997 and 2003 we conducted a large cross-sectional study on the characteristics of women around menopause attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. A total of 85,967 non-hysterectomized women not reporting myomectomy entered the study; 2239 had a diagnosis of uterine fibroids. A woman was defined as having uterine fibroids if she had at gynecological examination an enlarged uterus (2 months of gestation or more) and a clinical diagnosis of fibroids. In 769 cases was performed in ultrasound examination which confirmed the diagnosis. RESULTS: In comparison with women with a body mass index (BMI) <22, the multivariate ORs for BMI 26 or more were 1.30 (95% CI, 1.09-1.55) for cases with clinical diagnosis, and 1.29 (95% CI, 1.01-1.45) for women with ultrasonographic diagnosis. In comparison with premenopausal women, the multivariate OR for clinically detected fibroids was 0.63 (95% CI, 0.55-0.72) for post-menopausal ones. The risk of fibroids was lower in parous women than in nulliparous ones, and the risk decreased with number of births regardless the type of diagnosis. CONCLUSION: This study confirms in a large sample that parity is the main protective factor for the development of fibroids. Overweight increases the risk.

Age Factors↗
PubMed2002

Expression of progesterone receptors A and B and insulin-like growth factor-I in human myometrium and fibroids after treatment with a gonadotropin-releasing hormone analogue.

OBJECTIVE: To determine mRNA and protein expression of the progesterone receptor (PR) and insulin-like growth factor-I (IGF-I) in myometrium and fibroids. DESIGN: Retrospective clinical study. SETTING: Hospital-based and university-affiliated research laboratories. PATIENT(S): Twelve women in the proliferative phase and six women treated with GnRH analogue (GnRH-a). INTERVENTION(S): Blood sampling and collection of myometrium and fibroids. MAIN OUTCOME MEASURE(S): PR and IGF-I mRNA levels in fibroids and myometrium were analyzed by solution hybridization and in situ hybridization whereas the proteins were localized by immunohistochemistry. RESULT(S): Fibroids and myometrium from women in the proliferative phase showed significantly higher PR mRNA than the corresponding tissues from GnRH-a-treated women. The amount of cells positively stained for PR-AB and PR-B in fibroids and myometrium decreased after GnRH-a treatment compared with in the proliferative phase. The IGF-I mRNA in both fibroids and myometrium in the proliferative phase was significantly higher than those after GnRH-a treatment. The immunostaining of IGF-I showed no difference between the two tissues. There was weaker immunostaining in the GnRH-a-treated group compared with in the proliferative phase group. CONCLUSION(S): The shrinkage of fibroids after steroid deprivation is associated with alterations in PR and IGF-I expression.

Adult↗
PubMed2003

Doppler-ultrasound as a predictor of uterine fibroid response to GnRH therapy.

OBJECTIVES: GnRH agonists (GnRHa) are able to reduce the bleeding and size of fibroids. We monitored the response of fibroids to GnRHa with power-Doppler ultrasound. METHODS: Thirty-five women with fibroids, aged 32-48, received a 6-month course with the GnRHa triptorelin (Decapeptyl, Ipsen, France). The resistance index (RI) of the uterine artery was measured with power-Doppler ultrasound. RESULTS: The uterine volume reduced from 470+/-347 to 297+/-295 cm3 (P<0.01) at the 6th month of treatment. The fibroid volume reduced after 3 months of treatment from 62+/-81 to 44+/-78 cm3 (P<0.05) and after 6 months of treatment to 30+/-70 cm3 (P<0.001 from baseline). Uterine artery RI increased from 0.73+/-0.16 to 1.05+/-0.27 at the 3rd month of treatment (P<0.001). The percent reduction of fibroid volume at the 6th month correlated with the percent increase of uterine RI at the 3rd month of treatment (r=0.45, P=0.01). CONCLUSIONS: The administration of triptorelin reduced fibroid dimensions. The increase of the uterine artery resistance index (RI) at the 3rd month correlated with fibroid shrinkage at the 6th month of treatment and may be used to predict the response to this therapeutic maneuver.

Adult↗
PubMed2004

Medical management of uterine fibroids with medroxyprogesterone acetate (Depo Provera): a pilot study.

The aim of this study was to determine the effectiveness of medroxyprogesterone acetate (Depo Provera) in the treatment of menorrhagia attributed to uterine fibroids and to determine whether it reduces fibroid volume. Twenty premenopausal women with menorrhagia attributed to uterine fibroids received Depo Provera (150 mg/month) for 6 months. Control of bleeding was assessed by menstrual diary, haematologic parameters (Hb) and uterine and fibroid size measured sonargraphically. Following a period of 6 months after the initiation of Depo Provera, 30% became amenorrhoeic, 70% noticed improvement in their bleeding pattern and 15% had an increase in their haemoglobin levels. The mean uterine and fibroid volume was also reduced by 48% and 33%, respectively. Medical therapy with Depo Provera with symptomatic fibroids causes significant improvement in bleeding pattern as well as a reduction in fibroid volume.

Adult↗
PubMed2006

Endoscopic management of uterine fibroids.

Uterine fibroids are very common, but their relationship to fertility is still controversial. Data in relation to fibroids and fertility mainly come from retrospective case series and prospective uncontrolled trials. Although some authors advocate prospective controlled studies, it is unlikely that an easy answer will be found due to considerable variations in location, size and number of fibroids, presence of additional infertility factors and variation of surgical techniques. Submucosal fibroids are more likely to be associated with menstrual disorders and subfertility, and hysteroscopic myomectomy has been accepted as the standard treatment for them. Treatment of submucosal fibroids may be associated with better reproductive outcomes. There is bigger controversy over the impact of intramural and subserosal fibroids on fertility. Laparoscopic myomectomy is now used by a large number of groups for removal of these fibroids in selected cases, but still remains a challenging procedure which requires advanced laparoscopic skills. Its advantages over open myomectomy include reduced postoperative pain, shorter hospitalization, quicker recovery, reduced febrile morbidity and blood loss. It may also reduce the risk of postoperative adhesion formation. There are now large numbers of pregnancies following laparoscopic myomectomy and the risk of uterine rupture in future pregnancies seems to be very low with good surgical technique.

Endoscopes↗
PubMed2005

The economic impact of uterine fibroids in the United States: a summary of published estimates.

OBJECTIVE: To present a summary of published estimates of the economic burden of uterine fibroids in the United States and identify areas for additional research. METHODS: A search of three electronic databases, MEDLINE, EMBASE, and Current Contents, was conducted, along with a review of information on the Internet and abstraction of economic data. RESULTS: Only 10 papers and 1 Internet document met our inclusion criteria and were used to abstract data. Cost estimates for surgically invasive treatments of uterine fibroids included hysterectomy (USD 5,012-7,934), myomectomy (USD 5,425-11,839), and uterine artery embolization (UAE) (USD 5,425-7,645) (2004 USD). One cost-effectiveness study estimated lower costs and higher quality-adjusted life years with UAE compared with hysterectomy. A second study estimated potential savings of USD 4.2 million in hospital charges in the United States if higher rates of vaginal (vs. abdominal) hysterectomy would be achieved after pretreatment with gonadotropin hormone-releasing hormone (GnRH) agonists compared to without pretreatment with GnRH agonists (80% vs. 13%). There were no estimates of the total direct and indirect economic burden of uterine fibroids. Neither estimates of the costs for the ambulatory care of fibroids nor studies estimating the indirect costs associated with the management of fibroids and their symptoms were found. CONCLUSIONS: This summary of published U.S. economic estimates shows that despite the high prevalence of fibroids and their impact on clinical practice and women's lives, there is very little published information on their economic impact apart from data showing standard treatments for uterine fibroids are invasive and expensive. Reduction in the need for and cost of invasive procedures by the increased usage of noninvasive treatments could potentially achieve significant national cost savings, but further clinical and economic studies are needed.

Antineoplastic Agents, Hormonal↗
PubMed2002

Clinical outcomes following percutaneous magnetic resonance image guided laser ablation of symptomatic uterine fibroids.

BACKGROUND: Fibroids are common benign tumours of the uterus. Percutaneous magnetic resonance (MR) image guided laser ablation provides a minimally invasive, day-case alternative to surgery for the treatment of symptomatic fibroids. METHODS: Women with symptomatic fibroids wishing to avoid surgery were treated with laser ablation. MR thermal mapping ensured that maximal safe energy was applied. Fibroid volume was measured at 3 and 12 months, menstrual blood loss was recorded before and after treatment and a menorrhagia outcomes questionnaire (MOQ) was used to assess satisfaction. RESULTS: A total of 66 patients was treated. There was a significant (P < 0.001) reduction in mean fibroid volume of 31%. This was 41% at 1 year follow-up (P < 0.001). Measured menstrual blood loss in eight patients complaining of excessive bleeding was reduced (P = 0.012). The MOQ total outcome score was not as good as that seen in hysterectomy patients (P = 0.02) but the quality of life/satisfaction score was similar (P = 0.06). CONCLUSION: We have used objective and subjective outcome measures to determine the efficacy of MR guided laser ablation for fibroids. Based on this limited study we are encouraged that this procedure may represent a minimally invasive alternative therapy for fibroids.

Female↗
PubMed2004

Endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound in patients with small intramural uterine fibroids during IVF treatment.

BACKGROUND: The impact of intramural fibroids on the success of IVF treatment is controversial and the mechanisms leading to poor treatment outcomes remain unknown. We compared endometrial and subendometrial blood flow between women with and without intramural fibroids during IVF treatment. METHODS: Three-dimensional (3D) ultrasound examination with power Doppler was performed on the day of oocyte retrieval in 50 patients with intramural fibroids not distorting the uterine cavity and in 50 matched controls to measure endometrial thickness, uterine pulsatility index (PI)/resistance index (RI), endometrial volume and vascularization index (VI)/flow index (FI)/vascularization flow index (VFI) of endometrial and subendometrial regions. Smokers, patients with serum estradiol concentrations > or =20,000 pmol/l on the day of HCG and previous history of myomectomy were excluded. RESULTS: Endometrial thickness and pattern, averaged uterine PI and RI and endometrial and subendometrial VI/FI/VFI were similar between the fibroid group and the control group. There was no correlation between the total volume of fibroids and endometrial and subendometrial 3D power Doppler flow indices in the fibroid group. CONCLUSION: Endometrial and subendometrial 3D power Doppler flow indices were similar in patients with and without small intramural fibroids.

Adult↗
PubMed2006

The effect of fibroids without cavity involvement on ART outcomes independent of ovarian age.

BACKGROUND: The effect of fibroids that do not distort the endometrial cavity on pregnancy rate (PR) and implantation rate (IR) is controversial. Use of oocyte donor-derived embryos offers an ideal patient population to study the effect of fibroids in patients utilizing assisted reproductive technologies (ARTs). METHODS: We conducted a retrospective cohort study of patients undergoing oocyte donor recipient (ODR) IVF cycles at two tertiary care fertility centres. We examined medical records for the presence of non-cavity-distorting fibroids and evaluated subsequent PR and IR. RESULTS: Three hundred and sixty-nine patients, 94 with fibroids, underwent oocyte donor recipient transfer cycles with fresh embryos. There was no statistical difference in IR (36 versus 38%) or clinical PR (47 versus 54%) between patients with or without fibroids. Neither the location (subserosal versus intramural) and the presence of multiple myomas nor the size of the myomas affected outcomes. Fibroids were more likely to be present in patients with increasing recipient age. CONCLUSIONS: Clinical PR and IR are not affected by the presence of non-cavity-distorting leiomyomata. This evidence does not support myomectomy before ART in patients with asymptomatic fibroids that do not significantly distort the endometrial cavity or cause abnormal uterine bleeding.

Adult↗
PubMed2000

Tissue differences but limited sex steroid responsiveness of c-fos and c-jun in human fibroids and myometrium.

Sex steroids influence the growth of mammalian uterine tissues and the proto-oncogenes c-fos and c-jun have been implicated in the cascade of cellular events induced by the cyclic influence of oestrogen and progesterone. To investigate the role of these proto-oncogenes for fibroid growth their mRNA expression was measured in myometrium and fibroids under different hormonal conditions, using a solution hybridization method. Fibroids and myometrium were collected at surgery from premenopausal, postmenopausal and pregnant women as well as women treated with a gonadotrophin releasing hormone agonist (GnRHa; Goserelin). The phase of the menstrual cycle was determined in all the untreated, premenopausal, non-pregnant women. The mRNA expression of c-fos and c-jun in fibroids was significantly lower than in homologous myometrium. No significant differences in c-fos expression were observed in myometrium, or fibroids, due to menstrual cycle phase, GnRHa treatment, pregnancy or the menopause. The c-jun expression in myometrium from pregnant women without fibroid disease was significantly higher than the corresponding control myometrium from premenopausal, non-pregnant women. These results demonstrate a tissue difference in the expression of c-fos and c-jun between myometrium and fibroids.

Adult↗
PubMed1994

Messenger RNA encoding the insulin-like growth factors and their binding proteins, in women with fibroids, pretreated with luteinizing hormone-releasing hormone agonists.

The primary objective of this study was to suggest a possible mechanism of action of luteinizing hormone-releasing hormone agonist (LHRHa) on fibroids. This was performed by investigating insulin-like growth factor (IGF)-I, IGF-II and IGF binding protein (IGFBP)-1, -2 and -3 mRNA expression in uterine fibroids from women rendered hypo-oestrogenic by LHRHa, using Northern blot analysis. Nine women with fibroids, who were rendered hypo-oestrogenic from at least 4 months pretreatment with LHRHa therapy prior to undergoing myomectomy were investigated. Our results showed that IGF-I, IGF-II, IGFBP-2 and -3 mRNAs were expressed in uterine fibroids, and that IGFBP-1 mRNA or protein was not detected in fibroids. Western ligand blotting showed the presence of IGFBP-2 and -3 proteins, and when compared with a group of women with fibroids not treated with LHRHa (B.J. Vollenhoven et al., 1993, J. Clin. Endocrinol. Metab., 76, 1106-1110) we found that there was no difference in the relative abundance for each of the factors between the two groups of women. Therefore, LHRHa act to decrease fibroid size via induction of a hypo-oestrogenic state rather than by changes in the IGFs and their IGFBPs.

Adult↗
PubMed2003

Limited uterine artery embolization with tris-acryl gelatin microspheres for uterine fibroids.

PURPOSE: To evaluate the midterm results of limited embolization of the uterine arteries in the management of symptomatic uterine fibroids and to evaluate the efficacy and safety of limited uterine artery embolization (UAE) with use of calibrated tris-acryl gelatin microspheres in the management of symptomatic uterine fibroids. MATERIALS AND METHODS: Twenty women (mean age, 43 years) with symptomatic uterine fibroids underwent bilateral embolization of the uterine arteries with use of calibrated microspheres. Devascularization of the fibroids was achieved and the main uterine artery was left patent in all women. Embolization was offered as an alternative to surgery in all women who had been treated unsuccessfully with medical therapy. RESULTS: All procedures were technically successful. Microspheres 700-900 micro m in diameter were used in 14 women (70%). After a mean follow-up duration of 30.2 months (range, 24-48 mo), all women reported improvement in their symptoms, with 85% reporting complete resolution of menorrhagia at the most recent follow-up. One woman with multiple fibroids required a second embolization procedure because of persisting symptoms at 6 months. She is currently symptom-free after 48 months. In two women with submucosal fibroids, expulsion of necrotic fibroids occurred 2 and 7 months after the procedure, respectively. All women resumed normal menstruation after the procedure. One woman had a successful full-term pregnancy after embolization. CONCLUSION: Early experience with UAE with use of calibrated tris-acryl gelatin microspheres indicates that it is safe and efficacious in controlling menorrhagia.

Adult↗
PubMed1989

Long-term follow-up of patients with uterine fibroids after treatment with the LHRH agonist buserelin.

Ten patients with uterine fibroids palpable abdominally were treated with the luteinizing hormone-releasing hormone (LHRH) agonist buserelin, administered intransally, 300 micrograms three times daily, for 6 months, and were then followed for a further 12 months. Oestrogen levels were markedly reduced in all patients during treatment. At the end of treatment the mean volume reductions were 44.4% (SEM 3.5) for total uterine volume and 57.3% (SEM 7.4) for volume of discrete fibroids as assessed ultrasonically. There was also marked improvement in associated symptoms. After buserelin therapy was stopped, the total uterine and discrete fibroid volumes returned to, or slightly exceeded, pretreatment volumes within 6 months in five patients, and by 12 months in two patients. Three other patients who underwent surgery for their fibroids during the first 4 months after treatment showed regrowth of fibroids to pretreatment size. Four comparable asymptomatic untreated patients showed no significant change in the total uterine or fibroid volume during six monthly ultrasonic assessments. Buserelin therapy may facilitate rather than replace surgery in the management of uterine fibroids.

Adult↗
PubMed2005

Predictive factors for fibroids recurrence after uterine artery embolisation.

OBJECTIVES: To assess clinical failure and symptom recurrence after uterine artery embolisation (UAE) and to define predictive factors. DESIGN: Prospective study of a case series. SETTING: Gynaecology and radiology departments of a French University Hospital. POPULATION: Eighty-five women who underwent embolisation for the treatment of uterine fibroids. METHOD: Vascular access was obtained via the right common femoral artery. Free-flow embolisation was performed using 150-250 mum polyvinyl alcohol particles and an absorbable particle sponge. MAIN OUTCOME MEASURES: Clinical failure was defined as persistence of symptoms at three months of follow up and recurrence as return of symptoms. The main outcome measure was the need for further treatment after UAE. RESULTS: Results are available for 81 patients. Median follow up was 30 months. There were 15 clinical failures and recurrences requiring further treatment (eight hysterectomies, five hysteroscopic resections for submucous fibroids, one second embolisation and one woman refusing further treatment). Recurrence-free survival rate at 30 months (no clinical failure, no recurrence) was 82.8% (95% CI 73.7-91.8%). Multivariate analysis identified two predictive factors: dominant fibroid size on ultrasound imaging (each 1 cm increase: HR = 1.68, 95% CI 1.10-2.69) and number of fibroids (each additional fibroid: HR = 1.34, 95% CI 1.08-1.66). CONCLUSIONS: Symptom recurrence rate 30 months after fibroid embolisation was 17.2%. Fibroid size and number were predictive factors for recurrence. As most recurrences occurred after two years, we recommend that patients be monitored clinically and that imaging be for more than two years after UAE.

Adult↗
PubMed1986

Risk factors for uterine fibroids: reduced risk associated with oral contraceptives.

Risk factors for pathologically confirmed uterine leiomyomas (fibroids) were investigated using data from the Oxford Family Planning Association study, a long term follow up study of women using various methods of contraception. For each of 535 women who had had a fibroid an individual control was selected who matched the patient on age, date of entry into the cohort, and family planning clinic at recruitment and who was alive (and still being followed up) at the date the patient underwent surgery for fibroids. Case-control analysis showed that reproductive experiences were closely linked to development of fibroids. Risk of fibroids decreased consistently with increasing number of term pregnancies; women with five term pregnancies had only a quarter of the risk of women who had had none. Risk also decreased consistently with increasing duration of oral contraceptive use; the risk of fibroids was reduced by some 31% in women who had used oral contraceptives for 10 years. Risk was strongly related to weight: women who weighed under 55 kg had a particularly low risk, and overall the risk rose roughly 21% for each 10 kg increase. Cigarette smoking was associated with a decreased risk of fibroids; smokers of 20 cigarettes a day had a risk roughly two thirds that of non-smokers. These risk factors have all previously been identified as risk factors for endometrial cancer; this strongly suggests that the underlying risk factor is "unopposed" oestrogen.

Adult↗
PubMed2005

Uterine fibroids: diffusion-weighted MR imaging for monitoring therapy with focused ultrasound surgery--preliminary study.

PURPOSE: To prospectively determine the feasibility of using diffusion-weighted (DW) imaging and apparent diffusion coefficient (ADC) mapping before (baseline) and after treatment and at 6-month follow-up to monitor magnetic resonance (MR) image-guided focused ultrasound surgical ablation of uterine fibroids. MATERIALS AND METHODS: Informed consent was obtained from patients before treatment with our study protocol, as approved by the institutional review board, and the study complied with the Health Insurance Portability and Accountability Act. Fourteen patients (mean age, 46 years +/- 5 [standard deviation]) who underwent DW imaging were enrolled in this study, and 12 of 14 completed the inclusive MR examination with DW imaging at 6-month follow-up. Treatment was performed by one radiologist with a modified MR image-guided focused ultrasound surgical system coupled with a 1.5-T MR imager. Pre- and posttreatment and 6-month follow-up MR images were obtained by using phase-sensitive T1-weighted fast spoiled gradient-recalled acquisition, T1-weighted contrast material-enhanced, and DW imaging sequences. Total treatment time was 1-3 hours. Trace ADC maps were constructed for quantitative analysis. Regions of interest localized to areas of hyperintensity on DW images were drawn on postcontrast images, and quantitative statistics were obtained from treated and nontreated uterine tissue before and after treatment and at 6-month follow-up. Statistical analysis was performed with analysis of variance. Differences with P < .05 were considered statistically significant. RESULTS: T1-weighted contrast-enhancing fibroids selected for treatment had no hyperintense or hypointense signal intensity changes on the DW images or ADC maps before treatment. Considerably increased signal intensity changes that were localized within the treated areas were noted on DW images. Mean baseline ADC value in fibroids was 1504 mm(-6)/sec2 +/- 290. Posttreatment ADC values for nontreated fibroid tissue (1685 mm(-6)/sec2 +/- 468) differed from posttreatment ADC values for fibroid tissue (1078 mm(-6)/sec2 +/- 293) (P = .001). A significant difference (P < .001) between ADC values for treated (1905 mm(-6)/sec2 +/- 446) and nontreated (1437 mm(-6)/sec2 +/- 270) fibroid tissue at 6-month follow-up was observed. CONCLUSION: DW imaging and ADC mapping are feasible for identification of ablated tissue after focused ultrasound treatment of uterine fibroids.

Adult↗