Lohle Paul N M, De Vries Jolanda, Klazen Caroline A H, Boekkooi Peter F, Vervest Harry A M, Smeets Albert J, Lampmann Leo E H, Kroencke Thomas J
Department of Radiology, St Elisabeth Ziekenhuis, Tilburg University, Tilburg, The Netherlands.
J Vasc Interv Radiol. 2007 Jul;18(7):835-41. doi: 10.1016/j.jvir.2007.04.024.
To evaluate clinical and magnetic resonance (MR) imaging results after uterine artery embolization (UAE) in women with symptomatic adenomyosis with or without uterine leiomyomas.
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).
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.
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.
评估有症状的子宫腺肌病伴或不伴子宫肌瘤的女性患者接受子宫动脉栓塞术（UAE）后的临床及磁共振（MR）成像结果。
38例有症状的子宫腺肌病伴或不伴子宫肌瘤的女性患者接受了使用校准的三丙烯酸明胶微球的UAE治疗。根据MR检查结果，将患者分为单纯子宫腺肌病组（A组；n = 15）、子宫腺肌病为主合并肌瘤组（B组；n = 14）或肌瘤为主合并子宫腺肌病组（C组；n = 9）。
将末次随访（中位时间为16.5个月，范围3 - 38个月）时的月经过多、疼痛及与肿块相关的症状与基线症状进行比较。在中位时间为12个月（范围3 - 36个月）的随访MR成像中，评估子宫体积、肌瘤体积、结合带厚度及子宫腺肌病的对比增强变化。栓塞后，44.1%的病例在对比剂增强MR上可显示子宫腺肌病梗死。子宫体积、肌瘤体积及结合带厚度的中位缩小率分别为44.8%、77.1%和23.9%。A组中有3例患者在UAE后需要额外手术，B组有2例，C组有1例。在其余32例患者中，除C组1例患者外，所有既往症状（如出血、疼痛、与肿块相关的症状）在UAE后均得到改善或缓解。总体而言，84.2%的女性对UAE的结果满意。
在本研究中，中期结果（中位时间为16.5个月）表明，有症状的子宫腺肌病伴或不伴子宫肌瘤的女性患者接受UAE是有效的。绝大多数患者避免了子宫切除术。MR成像显示子宫体积和结合带厚度减小。
