Midterm results of uterine artery embolization for symptomatic adenomyosis: Initial experience
Midterm results of uterine artery embolization for symptomatic adenomyosis: Initial experience
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DOI：
10.1148/radiol.2343031697
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发表时间：
2005-03-01
期刊：
影响因子：
19.7
通讯作者：
Le Dref, O
中科院分区：
文献类型：
--
作者：
Pelage, JP;Jacob, D;Le Dref, O
目的：前瞻性评价子宫动脉栓塞治疗症状性脑卒中的中期疗效。材料和方法：研究方案经机构审查委员会批准，所有参与者均给予书面知情同意。18名有症状的女性（平均年龄44.3岁）采用双侧子宫动脉栓塞治疗。弥漫性子宫腺肌症的诊断是基于超声检查伴有子宫肌瘤囊肿的异质异常子宫肌瘤回声，或磁共振检查伴有子宫肌瘤囊肿和交界区增大。如果有类似于壁内肌瘤的界限分明的结节性病变，则诊断为局灶性子宫腺肌症。所有伴有子宫肌瘤的患者均被排除在外。栓塞术是所有女性子宫切除术的替代方法。定期进行临床评估以评估患者的预后。栓塞后6个月随访超声或磁共振成像评估子宫体积缩小。结果：使用聚乙烯醇颗粒或三丙基微球栓塞双侧子宫动脉的妇女除一人外均成功。手术后，所有女性都恢复了正常的月经。6个月后，16名妇女中有15名（94%）报告月经过多改善。6个月的随访图像显示，18名妇女中有17名（94%）的子宫体积略有减少（平均15%）。1年后，15名女性中有11名（73%）月经过多改善，15名女性中有8名（53%）月经过多完全缓解。2年后，9名女性中有5名（56%）月经过多完全消退。18名妇女中有8名（44%）在随访失败或复发期间需要额外治疗；5名妇女（28%）接受了子宫切除术。结论：即使子宫动脉栓塞治疗子宫腺肌症的短期效果令人鼓舞，中期结果令人失望，只有55%的治疗患者在2年后临床改善。(c) rsna, 2005。
PURPOSE: To prospectively evaluate the midterm results of uterine artery embolization for symptomatic adenomyosis.MATERIALS AND METHODS: The study protocol was approved by the institutional review board, and all participants gave written informed consent. Eighteen women (mean age, 44.3 years) with symptomatic adenomyosis were treated with bilateral embolization of the uterine arteries. The diagnosis of diffuse adenomyosis was based on heterogeneous abnormal myometrial echogenicity with myometrial cysts at ultrasonography (US) or on enlarged junctional zone and myometrial cysts at magnetic resonance (MR) imaging. Focal adenomyosis was diagnosed if there was-a circumscribed nodular lesion mimicking intramural fibroid. All patients with associated uterine fibroids were excluded. Embolization was offered as an alternative to hysterectomy in all women. Clinical evaluation was made at regular intervals to assess patient outcome. Follow-up US or MR imaging was performed 6 months after embolization to assess uterine volume reduction.RESULTS: Bilateral uterine artery embolization was achieved in all but one woman by using polyvinyl alcohol particles or trisacryl microspheres. All women resumed normal menstruation after the procedure. After 6 months, 15 (94%) of 16 women reported improvement in menorrhagia. Follow-up images at 6 months depicted a slight decrease (mean, 15%) in uterine volume in 17 (94%) of 18 women. After 1 year, 11 (73%) of 15 women had improvement in menorrhagia, and eight (53%) of 15, complete resolution. After 2 years, five (56%) of nine women had complete resolution of menorrhagia. Eight (44%) of 18 women required additional treatment during follow-up for failure or recurrence; five women (28%) underwent hysterectomy.CONCLUSION: Even if short-term results of uterine artery embolization to treat adenomyosis appear encouraging, midterm results are disappointing, with only 55% of treated patients showing clinical improvement after 2 years. (C) RSNA, 2005.