Contraindications and indications for ultrasound ablation for uterine fibroids

  Ultrasound ablation for uterine fibroids is not suitable for every patient with fibroids, such as patients with hypertension and myocardial infarction.  Contraindications: (1) uncontrolled hypertension; (2) history of cerebrovascular accident; (3) history of myocardial infarction; (4) history of collagenous connective tissue disease; (5) history of abdominal radiotherapy; Indications for treatment: (1) clearly diagnosed fibroids, excluding uterine sarcoma, other lesions of the uterus and non-benign cervical lesions; (2) fibroids that can be visualized by ultrasound monitoring of the treatment equipment.  Relative indications (conditions that can be treated with some medical treatment): (1) cervical fibroids, submucosal and subplasma fibroids with tissues, and vascular smooth muscle tumors; (2) acute and chronic pelvic inflammatory disease; (3) history of multiple lower abdominal surgeries, history of intestinal adhesions, and foreign body placement on the lower abdominal acoustic channel; (4) surgical scars with a hard texture on the lower abdominal wall that have significant attenuation of the visualized ultrasound; (5) (5) Those who cannot insist on continuous prone for more than 1 hour.  Focused ultrasound does not have enough energy to cause tissue damage at the non-treatment site it crosses. In its focus, due to the high sound intensity, the thermal effect of ultrasound causes the temperature of the tissue to rise instantly to 65-100 degrees, resulting in protein denaturation and coagulative necrosis of tissue cells; at the same time, the cavitation effect of ultrasound causes the formation of bubbles in the intercellular fluid, intercellular fluid and intracellular gas molecules under the action of positive and negative pressure phase of ultrasound, and then contraction and expansion to the final burst, the energy generated The resulting energy causes cell damage and necrosis.  The morphology and size of the focal field of focused ultrasound, as well as the effect and reaction of the tissue to ultrasound, play a decisive role in the depth of ultrasound treatment, the extent of tissue damage and the degree of damage. Therefore, by setting the parameters of the ultrasound transducer it is possible to achieve the goal of targeting and destroying the lesion without damaging the tissues around the treatment target, thus achieving the goal of non-invasive treatment.