Uterine artery embolization for symptomatic adenomyosis with or without uterine leiomyomas with the use of calibrated tris-acryl gelatin microspheres: Midterm clinical and MR imaging follow-up
Uterine artery embolization for symptomatic adenomyosis with or without uterine leiomyomas with the use of calibrated tris-acryl gelatin microspheres: Midterm clinical and MR imaging follow-up
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DOI：
10.1016/j.jvir.2007.04.024
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发表时间：
2007-07-01
影响因子：
2.9
通讯作者：
Kroencke, Thomas J.
中科院分区：
文献类型：
--
作者：
Lohle, Paul N. M.;Vries, Jolanda De;Kroencke, Thomas J.
目得：目的：评价子宫动脉栓塞（UAE）治疗有症状子宫腺肌病伴或不伴子宫平滑肌瘤患者的临床和磁共振（MR）成像结果。材料和方法：38例有症状的子宫腺肌病伴或不伴子宫平滑肌瘤的妇女接受了经校准的三丙烯酸明胶微球UAE治疗。根据磁共振检查结果，妇女被归类为有纯粹的子宫腺肌病A组（n = 15），子宫腺肌症为主伴纤维瘤（B组; n = 14），或子宫腺肌症的纤维瘤优势C组9例。末次随访（中位时间16.5个月）时月经大量出血、疼痛和肿块相关症状（范围，3-38个月）与基线症状进行比较。在中位12个月（范围3-36个月）的随访MR成像中，评估子宫体积、平滑肌瘤体积、交界区厚度和子宫腺肌病的对比增强的变化。栓塞后，44.1%的子宫腺肌症梗死可在增强MR上显示。子宫体积、肌瘤体积和交界区厚度的中位减少分别为44.8%、77.1%和23.9%。在A组中，除了B组2例和C组1例之外，有3例患者在UAE后需要额外手术。在其余32例患者中，除C组的1例患者外，所有既存症状（例如出血、疼痛、肿块相关症状）在UAE后均改善或消退。总体而言，84.2%的妇女满意UAE的结果。结论：在这项研究中，中期结果（中位数为16.5个月）表明，UAE在有症状的子宫腺肌病伴或不伴子宫平滑肌瘤是有效的。绝大多数患者避免了子宫切除术。MR成像显示子宫体积缩小，结合带厚度减少。
PURPOSE: To evaluate clinical and magnetic resonance (MR) imaging results after uterine artery embolization (UAE) in women with symptomatic adenomyosis with or without uterine leiomyomas. MATERIALS ANDMETHODS: Thirty-eight women with symptomatic adenomyosis with or without uterine leiomyomas were treated with UAE with calibrated tris-acryl gelatin microspheres. Based on MR findings, women were categorized as having pure adenomyosis (group A; n = 15), adenomyosis dominance with fibroid tumors (group B; n = 14), or fibroid tumor dominance with adenomyosis (group C; n = 9).RESULTS: Heavy menstrual bleeding, pain, and bulk-related symptoms at last follow-up at a median of 16.5 months (range, 3-38 months) were compared with baseline symptoms. With follow-up MR imaging at a median of 12 months (range, 3-36 months), changes in uterine volume, leiomyoma volume, junctional zone thickness, and contrast enhancement of adenomyosis were assessed. After embolization, adenomyosis infarction could be depicted on contrast medium-enhanced MR in 44.1% of cases. Median reductions of uterine volume, fibroid tumor volume, and junctional zone thickness were 44.8%, 77.1%, and 23.9%, respectively. In group A, three patients needed additional surgery after UAE, in addition to two in group B and one in group C. In the remaining 32 patients, except for one patient in group C, all preexisting symptoms (eg, bleeding, pain, bulk-related symptoms) improved or resolved after UAE. Overall, 84.2% of women were satisfied with the results of UAE.CONCLUSION: In this study, midterm results (at a median of 16.5 months) showed that UAE in symptomatic adenomyosis with or without uterine leiomyomas is effective. Hysterectomy was avoided in the vast majority of patients. MR imaging showed reduction of uterine volume and junctional zone thickness.