Uterine fibroids: contrast-enhanced MR angiography to predict ovarian artery supply--initial experience.
Uterine fibroids: contrast-enhanced MR angiography to predict ovarian artery supply--initial experience.
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DOI：
10.1148/radiol.2411051075
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发表时间：
2006-10
期刊：
影响因子：
19.7
通讯作者：
T. Kroencke;C. Scheurig;C. Kluner;M. Taupitz;J. Schnorr;B. Hamm
中科院分区：
文献类型：
--
作者：
T. Kroencke;C. Scheurig;C. Kluner;M. Taupitz;J. Schnorr;B. Hamm
目的：以栓塞后常规主动脉造影作为参考标准，前瞻性评价对比剂增强磁共振（MR）血管造影在帮助预测子宫肌瘤卵巢动脉供血方面的诊断性能。材料和方法研究方案由机构审查委员会批准，每位患者均给予知情同意。连续90例女性（平均年龄42.5岁;范围33-63岁）在子宫动脉栓塞（UAE）前接受了MR血管造影。测定卵巢动脉的数目和来源。根据磁共振血管造影结果的组合，使用评分系统将肌瘤的卵巢动脉供应分级为非常不可能、可能或非常可能。将所有患者的MR血管造影结果与UAE后进行的常规卵巢动脉造影结果进行比较，并在怀疑卵巢动脉供应肌瘤的情况下进行选择性血管造影。采用卡方（2）趋势检验分析MR血管造影分级与作为参考标准的常规血管造影之间的相关性。确定MR血管造影的敏感性和特异性，包括精确的95%置信区间（CI）。结果MR血管造影显示卵巢动脉18条（双侧4条，单侧10条），其中1条起源不典型。5条卵巢动脉被归类为非常可能; 3条，可能; 10条，作为动脉肌瘤供应的非常不可能来源。7（39%）的18个卵巢动脉检测到磁共振血管造影是可见的，在传统的卵巢动脉造影。90例患者中有5例（6%）在5条卵巢动脉的选择性血管造影中证实了肌瘤的供应。MR血管造影分级与常规血管造影结果之间存在强相关性（P = 0.002）。MR血管造影显示卵巢动脉供血（分级、可能或非常可能）的敏感性为100%（5/5，95%CI：48%; 100%），特异性为77%（10/13，95%CI：46%; 95%）。结论增强磁共振血管成像有助于预测子宫肌瘤的卵巢动脉供血情况。
PURPOSE To prospectively evaluate the diagnostic performance of contrast material-enhanced magnetic resonance (MR) angiography in helping predict ovarian artery supply of uterine fibroids by using postembolization conventional aortography as the reference standard. MATERIALS AND METHODS The protocol for the study was approved by the institutional review board, and each patient gave informed consent. Ninety consecutive women (mean age, 42.5 years; range, 33-63 years) underwent MR angiography before uterine artery embolization (UAE). The number and origin of the ovarian arteries were determined. Ovarian artery supply of fibroids was graded as very unlikely, possible, or very likely by using a scoring system based on a combination of MR angiographic findings. MR angiographic results were compared with those of conventional aortography performed after UAE in all patients and followed by selective angiography in case of a suspected ovarian artery supply of fibroids. Analysis of the association between MR angiographic grading and conventional angiography as the standard of reference was performed with a chi(2) trend test. Sensitivity and specificity, including exact 95% confidence intervals (CIs), of MR angiography were determined. RESULTS MR angiography depicted 18 ovarian arteries (four bilateral, 10 unilateral), one with an atypical origin. Five ovarian arteries were classified as very likely; three, as possible; and 10, as very unlikely sources of arterial fibroid supply. Seven (39%) of 18 ovarian arteries detected at MR angiography were visible at conventional aortography. Fibroid supply was verified at selective angiography in five ovarian arteries in five (6%) of 90 patients. There was a strong association between MR angiographic grading and the results of conventional angiography (P = .002). Sensitivity of MR angiography in depicting ovarian artery supply (grade, possible or very likely) was 100% (five of five, 95% CI: 48%; 100%) and specificity was 77% (10 of 13, 95% CI: 46%; 95%). CONCLUSION Contrast-enhanced MR angiography can help predict ovarian artery supply of uterine fibroids.