Dixon Shaheen, Tapping Charles Ross, Chuah Phei Shan, Bratby Mark, Uberoi Raman, Anthony Susan
Department of Radiology, The John Radcliffe Hospital, Oxford, UK.
Acta Radiol. 2012 Apr 1;53(3):292-5. doi: 10.1258/ar.2011.110518. Epub 2012 Feb 14.
A 47-year-old woman with a history of myomectomies and uterine artery embolization 15 years previously presented with increasing menorrhagia and dysmenorrhea. Magnetic resonance imaging (MRI) demonstrated multiple enhancing fibroids, extensive uterine supply from what appeared to be patent uterine arteries, and significant supply from what appeared to be the left ovarian artery. Aortography demonstrated no ovarian supply, but extensive collateral supply from distal branches of the inferior mesenteric artery (IMA), with further collateral supply from the anterior division of both internal iliac arteries. There was no filling of the uterine arteries distal to the coils. Embolization was performed with technical and clinical success. This case highlights the potential for recruitment of collateral vessels following coil embolization and is the first reported case of successful fibroid embolization from distal IMA branches.
一名47岁女性，有15年前子宫肌瘤切除术和子宫动脉栓塞术病史，现出现月经过多和痛经加重。磁共振成像（MRI）显示多个强化肌瘤，子宫似乎由通畅的子宫动脉广泛供血，且似乎由左卵巢动脉大量供血。主动脉造影显示无卵巢供血，但有来自肠系膜下动脉（IMA）远端分支的广泛侧支供血，双侧髂内动脉前支还有进一步侧支供血。线圈远端的子宫动脉未显影。栓塞术取得了技术和临床成功。该病例突出了线圈栓塞后侧支血管募集的可能性，是首例报道的从IMA远端分支成功进行肌瘤栓塞的病例。
