Bratby M J, Walker W J
Radiology Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 7XX, United Kingdom.
Eur J Radiol. 2009 Apr;70(1):128-32. doi: 10.1016/j.ejrad.2007.12.009. Epub 2008 Feb 15.
To evaluate the role of uterine artery embolisation (UAE) in the treatment of adenomyosis.
27 women with symptomatic adenomyosis diagnosed on magnetic resonance imaging (MRI) underwent UAE between 1998 and 2004. Clinical evaluation using a standardised questionnaire was made at regular intervals after embolisation to assess patient outcome.
The diagnosis of adenomyosis was confirmed histologically by transvaginal biopsy in 5 women. There were 14 women with associated uterine fibroids. Diffuse adenomyosis was identified in 18 women. A focal adenomyoma was present in another 8 women. In 1 patient adenomyosis was not classified. All patients except one underwent bilateral uterine artery embolisation. There was an initial favourable clinical response, with improvement of menorrhagia in 79% (13/16) of patients at 12 months. Follow-up data was available on a total of 14 patients at 2 and 3 years after embolisation. 45.5% (5/11) reported a deterioration in menorrhagia symptoms at 2 years.
UAE for symptomatic adenomyosis is effective in the short-term but there is a high rate of recurrence of clinical symptoms 2 year following treatment.
评估子宫动脉栓塞术（UAE）在治疗子宫腺肌病中的作用。
1998年至2004年间，27例经磁共振成像（MRI）诊断为有症状子宫腺肌病的女性接受了UAE治疗。栓塞术后定期使用标准化问卷进行临床评估，以评估患者的治疗效果。
5例女性经阴道活检组织学确诊为子宫腺肌病。14例女性伴有子宫肌瘤。18例女性为弥漫性子宫腺肌病。另外8例女性存在局灶性腺肌瘤。1例患者的子宫腺肌病未分类。除1例患者外，所有患者均接受了双侧子宫动脉栓塞术。最初临床反应良好，12个月时79%（13/16）的患者月经过多症状得到改善。栓塞术后2年和3年共有14例患者有随访数据。45.5%（5/11）的患者在2年时报告月经过多症状恶化。
UAE治疗有症状的子宫腺肌病在短期内有效，但治疗后2年临床症状复发率较高。
