Kim Hyun S, Thonse Vinutha R, Judson Kara, Vang Russell
Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
J Vasc Interv Radiol. 2007 Jan;18(1 Pt 1):31-9. doi: 10.1016/j.jvir.2006.10.008.
To study utero-ovarian anastomosis at angiography and its histologic effect on patients who were treated with uterine artery embolization (UAE) with or without ovarian artery embolization (OAE) for symptomatic uterine leiomyomata.
Four hundred patients (mean age, 43.6 years +/- 6.34) underwent UAE at the authors' institution from June 1998 to May 2005. Eight of the 400 patients underwent hysterectomy with removal of at least one adnexae after UAE. Five patients received tris-acryl gelatin microspheres and three received polyvinyl alcohol particles. Two patients also underwent OAE with gelatin sponges. Specimens from 16 fallopian tubes and 12 ovaries were reviewed. Histologic slides were prepared and reviewed by two pathologists who were blinded to the angiographic findings. The presence of utero-ovarian anastomoses at angiography, the histologic features of adnexa, the presence of particles in the adnexa, and the size and location of the particles were studied.
Utero-ovarian anastomosis was present at angiography in three of the eight patients (38%) and five of the 16 adnexa (31%). Particles were present within the fallopian tube or ovary in all patients who demonstrated utero-ovarian anastomoses at angiography. When utero-ovarian anastomoses were identified bilaterally, particles were found in both adnexae. In cases with particles in the adnexa, the adnexal tissues were histologically viable without evidence of ischemic changes or infarction. Particles were not present in the ovary of patients without utero-ovarian anastomosis at angiography.
The angiographic finding of a utero-ovarian anastomosis during UAE appears to correlate with particle embolization in the fallopian tube or ovary. Histologically normal fallopian tubes and ovaries can be expected after UAE with microsphere particles with and without OAE with gelatin sponges.
研究血管造影术中子宫 - 卵巢吻合情况及其对因症状性子宫平滑肌瘤接受子宫动脉栓塞术（UAE）联合或不联合卵巢动脉栓塞术（OAE）治疗的患者的组织学影响。
1998年6月至2005年5月，400例患者（平均年龄43.6岁±6.34岁）在作者所在机构接受了UAE。400例患者中有8例在UAE后接受了子宫切除术并至少切除了一个附件。5例患者接受了三丙烯酸明胶微球，3例接受了聚乙烯醇颗粒。2例患者还接受了用明胶海绵进行的OAE。对16条输卵管和12个卵巢的标本进行了检查。由两位对血管造影结果不知情的病理学家制备并检查组织学切片。研究了血管造影术中子宫 - 卵巢吻合的存在情况、附件的组织学特征、附件中颗粒的存在情况以及颗粒的大小和位置。
8例患者中有3例（38%）、16个附件中有5个（31%）在血管造影术中存在子宫 - 卵巢吻合。在血管造影术中显示子宫 - 卵巢吻合的所有患者的输卵管或卵巢内均有颗粒。当双侧发现子宫 - 卵巢吻合时，两个附件中均发现有颗粒。在附件中有颗粒的病例中，附件组织在组织学上是存活的，没有缺血改变或梗死的证据。在血管造影术中无子宫 - 卵巢吻合的患者的卵巢中未发现颗粒。
UAE期间血管造影发现子宫 - 卵巢吻合似乎与输卵管或卵巢中的颗粒栓塞相关。使用微球颗粒联合或不联合用明胶海绵进行OAE的UAE后，预计输卵管和卵巢在组织学上是正常的。
