Department of Diagnostic Radiology and Nuclear Medicine, Kyoto University, 57 Shogoin Kawaharacho, Sakyo-ku, Kyoto City, Kyoto, Japan 6068507.
AJR Am J Roentgenol. 2011 Jun;196(6):1431-5. doi: 10.2214/AJR.10.5349.
The purpose of this article is to compare uterine peristalsis before and after uterine artery embolization (UAE) on a 3-T MRI system.
MRI scans were prospectively performed for 20 women with symptomatic uterine fibroids (age range, 39-53 years) before and after UAE in the periovulatory phase with a 3-T scanner. Sagittal T2 turbo spin-echo sequences and a HASTE sequence were obtained. Sixty HASTE images were obtained for 3 minutes to display on cine mode. Two radiologists independently evaluated the datasets for the presence of uterine peristalsis using a 5-point rating scale. When peristalsis was present, the direction and frequency were recorded. The images were also evaluated for index fibroid location before and after UAE, index fibroid volume, uterine volume, and fibroid burden estimate.
The presence and frequency of uterine peristalsis increased after UAE for both readers, but was significant only for the presence of uterine peristalsis. The majority of patients had peristalsis in the cervix-to-fundus direction. In six cases, uterine peristalsis emerged after UAE. Uterine volumes before UAE were significantly smaller in these six cases compared with the remaining 14 cases, though no significant difference was found in the reduction rate of the uterus or fibroid volumes. The index fibroid was intramural in three of the six cases with interval appearance of peristalsis. The fibroid was solitary in four of the six cases.
Cine MRI at 3 T may show recovery of uterine peristalsis in some women with symptomatic fibroids after successful UAE.
本文旨在比较 3T MRI 系统子宫动脉栓塞术（UAE）前后子宫蠕动的变化。
前瞻性纳入 20 例症状性子宫肌瘤（年龄 39-53 岁）女性，于排卵前期在 3T 扫描仪上行 MRI 检查。扫描序列包括矢状位 T2 涡轮自旋回波序列和 HASTE 序列。共采集 60 幅 HASTE 图像，以电影模式显示 3 分钟。两名放射科医生使用 5 分制独立评估数据集，评估 UAE 前后子宫蠕动的存在、方向和频率。评估内容还包括 UAE 前后子宫肌瘤的位置、体积、子宫体积和肌瘤负担。
两名放射科医生均发现 UAE 后子宫蠕动的存在和频率增加，但仅存在子宫蠕动有统计学意义。大多数患者的蠕动方向为宫颈至宫底。在 6 例患者中，UAE 后出现子宫蠕动。这 6 例患者 UAE 前子宫体积明显小于其余 14 例，尽管子宫或肌瘤体积减少率无显著差异。其中 3 例蠕动出现间隔的患者子宫肌瘤为壁间型，4 例患者子宫肌瘤为单发。
3T 磁共振电影成像可能显示部分症状性子宫肌瘤患者在成功 UAE 后子宫蠕动恢复。
