Objective To investigate the therapeutic effectiveness and safety of high intensity focused ultrasound (HIFU) ablation for large uterine fibroids. Methods 33 large uterine fibroids in 32 patients were treated with HIFU. MRI and ultrasound were used to assess and evaluate the treatment response. Adverse effects were recorded. Results MRI showed that the average tumor size was (11. 7+ 1. 9) cm in diameter before treatment. The massive grey scale change was observed in all of the treated fibroids. The average sonication time to achieve massive grey scale change was(105 + 244) seconds. The fractional ablation was (82. 6+14. 1)%. The shrinkage rate at 1 month, 3 month, and 6 month was ( 32. 1 + 22. 0 ) % , ( 44. 1 ± 21. 9 ) % and ( 55. 5 ± 19. 2 ) % , respectively. During HIFU procedure,. 6 (18. 8%) patients complained sacral pain or leg pain,13(40. 6%) patients complained pain on the skin of lower abdomen,14 (43. 4% ) patients had vaginal discharge. No complication was observed. Conclusions HIFU is safe and effective in ablating large uterine fibroids.%目的 研究实时超声监控下高强度聚焦超声(HIFU)消融治疗子宫大肌瘤的有效性及安全性.方法 32例肌瘤最大径＞10 cm的子宫肌瘤患者接受HIFU治疗.治疗前及治疗后第1天行彩超及增强磁共振(MRI)检查；治疗后1、3、6个月行彩超或MRI随访.分析治疗中、治疗后所有副反应.结果 术前MRI显示子宫肌瘤平均最大直径为(11.7±1.9) cm,子宫肌瘤平均体积为(572.1±421.7) cm3;术中团块状灰度出现率为100％,团块状灰度出现时间为(105±244)s；术后增强MRI显示子宫肌瘤平均消融率分别为(82.6±14.1)％.HIFU治疗后1、3、6个月子宫肌瘤缩小率分别为(32.1±22.0)％、(44.1±21.9)％和(55.5±19.2)％.术中18 (56.3％)例患者诉骶尾部疼痛；1 9(59.4％)例患者诉治疗区疼痛；14 (43.8％)例患者诉皮肤烫感.术后无特殊不适.结论 超声引导的高强度聚焦超声能安全、有效地治疗子宫大肌瘤患者.
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