J Korean Soc Radiol.  2019 May;80(3):579-584. 10.3348/jksr.2019.80.3.579.

Complication Following Ultrasound-Guided High-Intensity Focused Ultrasound for the Treatment of Uterine Adenomyosis: Case Report of CT Imaging Features

• Hong SH
• Hong GS
• Lee CW
• Kim GH

• KMID: 2454039
• DOI: http://doi.org/10.3348/jksr.2019.80.3.579

Abstract

High intensity focused ultrasound (HIFU) is a non-surgical and non-invasive treatment option in patients with uterine myoma and adenomyosis. As the use of HIFU increases in the clinical practice, it is important to be aware of imaging findings related to ultrasound (US)-guided HIFU ablation and its potential complications. However, there are few reports on the imaging findings regarding complications of US-guided HIFU ablation. Here, we report a case of acute complication after US-guided HIFU ablation, surgically confirmed as thermal injury with necrosis of skin, subcutaneous tissue, anterior abdominal wall muscles, peritoneum and uterus.

MeSH Terms

Abdominal Injuries
Abdominal Wall
Adenomyosis*
Humans
Leiomyoma
Muscles
Necrosis
Peritoneum
Skin
Subcutaneous Tissue
Tomography, Spiral Computed
Ultrasonography*
Uterus

Figure

• 

  Fig. 1 Complication following ultrasound-guided HIFU ablation for uterine adenomyosis in a 44-year-old woman, presenting with low abdominal pain. A, B. Axial CT image shows overlying skin thickening, non-enhancing thickening of the superficial and deep fascia at the anterior pelvic wall, peritoneal thickening with fat infiltration in the pelvic cavity, and non-enhancement at bilateral rectus abdominis muscles (A, B; arrowheads). Note the sharply demarcated zone of hypodensity with linear lateral margins at the anterior portion of the uterus (B, arrow). C, D. Coronal reconstructed CT image shows area of non-enhancement at the bilateral rectus abdominis muscles (C, arrowheads) and zone of hypodensity at the anterior portion of the uterus (D, arrow). E, F. Photos show (E) skin necrosis in the treated area and (F) thermal injury with necrosis (arrow) on the uterine anterior wall in the surgical field. HIFU = high intensity focused ultrasound

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