Abstract: Objective： To evaluate the efficacy of the ultrasound ablation with real-time ultrasonic monitoring in adenomyosis treatment and the effect on life quality. Methods：35 patients with adenomyosis were treated with the high intensity focused ultrasound（HIFU）. The effecacy of ablation was evaluate by the enhanced MRI. The lesions were monitored by the color Doppler ultrasound. Clinical symptoms，life quality，the side effects after treatment，as well as prognosis，were recorded by the standard UFS-QOL measuring scale. Results：The ablation ratio of adenomyosis lesion detected by the enhanced dynamic MRI was （68.9±18.9）% on the 2nd day after treatment. All side effects after treatment were under the B-level of the standard classification of International Association of Interventional Radiology （SIR）. The size of adenomyosis lesion before treatment [approximately 36.9（20.5，44.8） cm3] was significantly bigger than that after one month of treatment [19.1（12.1，31.1） cm3]（Z=2.801，P=0.005）. The UFS score before treatment [22.5（17.5，32.5）] was higher than that after one month of treatment [15.0（7.5，25.0）]（Z=3.695，P=0.000）. However，the QOL before treatment was （77.9±10.5） while the QOL after one month of treatment was（81.4±13.3），respectively （t=1.230，P=0.223）. Dysmenorrheal was significantly relieved（Zc=7.280，P=0.000）. Conclusions：The ultrasound-guided high intensity focused ultrasound ablation is effective in treatment of adenomyosis，the associated clinical symptoms can be significantly relieved and the size of lesions be significantly reduced. It is a longer follow-up time to improve the quality of life.

Key words: Ultrasonography, Doppler, color, Magnetic resonance imaging, Endometriosis, Treatment outcome, High intensity focused ultrasound