Kim Hyun S, Tsai Jason, Lee Judy M, Vang Russell, Griffith John G, Wallach Edward E
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Blalock 545, Baltimore, Maryland 21205-4010, USA.
J Vasc Interv Radiol. 2006 Jun;17(6):965-71. doi: 10.1097/01.RVI.0000220425.23309.15.
To assess the prevalence of anastomoses between uterine and ovarian arteries on angiography and their impact on changes in basal follicle-stimulating hormone (FSH) level after uterine artery embolization (UAE).
Consecutive premenopausal women who underwent UAE for symptomatic uterine leiomyomata according to a uniform embolization technique with tris-acryl gelatin microspheres at a single institution were included in the study. Basal FSH levels before UAE and 6 months after UAE were compared for patients with and without anastomoses between uterine and ovarian arteries on angiography.
Among 124 patients included in the study (mean age, 43.1+/-5.7 years), patent anastomoses between the uterine and ovarian arteries were detected by angiography in 55 patients (44.4%). Overall, 11.3% of 124 patients showed an increase in basal serum FSH level of greater than 20 mIU/mL after UAE. In patients with utero-ovarian anastomoses, 18.2% showed an increase of greater than 20 mIU/mL after UAE, compared with 5.8% of patients without such anastomoses (P=.03). Mean basal FSH increase after UAE in patients with anastomoses was 8.4+/-20.2 mIU/mL, compared with 2.7+/-10.6 mIU/mL in patients without anastomoses (P=.047). Among patients with anastomoses, the 50- to 54-year age group had the highest percentage of patients with an FSH increase greater than 20 mIU/mL (50.0%) after UAE, followed by patients in the 45- to 49-year age group (15.4%).
Angiographically detected anastomoses between the uterine artery and the ovarian artery are not uncommon. UAE in patients with anastomoses is associated with a greater risk of significant increase of basal FSH level than in UAE in patients without anastomoses. The pathophysiologic processes resulting in change of FSH level may be a reflection of diminished ovarian function, but further study is warranted to delineate the precise mechanism.
评估子宫动脉造影时子宫动脉与卵巢动脉之间吻合支的发生率及其对子宫动脉栓塞术（UAE）后基础卵泡刺激素（FSH）水平变化的影响。
本研究纳入了在单一机构按照统一栓塞技术使用三丙烯酸明胶微球对有症状子宫肌瘤进行UAE的连续绝经前女性。比较了子宫动脉造影显示子宫动脉与卵巢动脉之间有或无吻合支的患者在UAE前和UAE后6个月的基础FSH水平。
在纳入研究的124例患者（平均年龄43.1±5.7岁）中，血管造影检测到55例患者（44.4%）子宫动脉与卵巢动脉之间存在通畅的吻合支。总体而言，124例患者中有11.3%在UAE后基础血清FSH水平升高超过20 mIU/mL。在有子宫 - 卵巢吻合支的患者中，18.2%在UAE后升高超过20 mIU/mL，而无此类吻合支的患者为5.8%（P = 0.03）。有吻合支的患者UAE后基础FSH平均升高8.4±20.2 mIU/mL，无吻合支的患者为2.7±10.6 mIU/mL（P = 0.047）。在有吻合支的患者中，50至54岁年龄组在UAE后FSH升高超过20 mIU/mL的患者比例最高（50.0%），其次是45至49岁年龄组的患者（15.4%）。
血管造影检测到的子宫动脉与卵巢动脉之间的吻合支并不罕见。有吻合支的患者进行UAE比无吻合支的患者发生基础FSH水平显著升高的风险更大。导致FSH水平变化的病理生理过程可能反映了卵巢功能减退，但需要进一步研究以阐明确切机制。
