Department of Internal Medicine, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA.
J Vasc Interv Radiol. 2011 Jun;22(6):865-9. doi: 10.1016/j.jvir.2011.02.008. Epub 2011 Apr 20.
To determine the prevalence, predisposing factors, and resolution of hydronephrosis among patients undergoing uterine artery embolization (UAE) for fibroids.
From October 2004 to May 2008, 1,114 patients underwent UAE at an academic medical center. Hydronephrosis was found on angiographic images in 101 patients. In 34 of these patients, 3-month ultrasound follow-up was available. The angiographic images were graded for hydronephrosis severity by three interventional radiologist reviewers. The degree of residual hydronephrosis was obtained from ultrasound images or reports in 3-month follow-up imaging. Descriptive statistics summarizing outcomes and interobserver agreement regarding hydronephrosis grade were calculated. In a parallel assessment, prospectively gathered baseline data available from 776 patients undergoing UAE were analyzed to identify predisposing factors to hydronephrosis.
Among the 34 patients with hydronephrosis and appropriate follow-up, resolution occurred in 28 of 34 (82%) patients. Among the entire study group, 9.0% (101 of 1,114) of patients had unilateral or bilateral hydronephrosis. Hydronephrosis was less frequent in left kidneys (4.5% [35 of 776]) than right kidneys (6.3% [49 of 776]; P = .013). The mean uterine volume in the group with hydronephrosis was greater than in the group without hydronephrosis (1,041 cm(3) vs 609 cm(3); P < .0001), and the mean dominant fibroid volume was also greater (233 cm(3) vs 147 cm(3); P < .0001).
These results suggest that UAE may result in resolution of hydronephrosis in a notable number of cases. Large uterine size and dominant fibroid size was associated with hydronephrosis.
确定行子宫动脉栓塞术（UAE）治疗子宫肌瘤患者中肾积水的发生率、易患因素和转归。
2004 年 10 月至 2008 年 5 月，在一家学术医疗中心对 1114 例患者进行了 UAE。101 例患者的血管造影图像发现有肾积水。在这些患者中，有 34 例患者进行了 3 个月的超声随访。3 位介入放射科医生对血管造影图像的肾积水严重程度进行分级。在 3 个月的随访成像中，从超声图像或报告中获得残余肾积水的程度。计算了总结结局的描述性统计数据和肾积水分级的观察者间一致性。在并行评估中，分析了前瞻性收集的 776 例行 UAE 患者的基线数据，以确定肾积水的易患因素。
在有肾积水和适当随访的 34 例患者中，28 例（82%）患者的积水得到缓解。在整个研究组中，1114 例患者中有 9.0%（101 例）出现单侧或双侧肾积水。左肾（4.5%[35/776]）肾积水的发生率低于右肾（6.3%[49/776]；P=.013）。积水组的子宫体积均值大于无积水组（1041cm³比 609cm³；P<.0001），优势肌瘤体积也更大（233cm³比 147cm³；P<.0001）。
这些结果表明，UAE 可能在相当多的病例中导致肾积水缓解。子宫体积大和优势肌瘤体积与肾积水有关。
