Franiel Tobias, Aschenbach René, Trupp Sarah, Lehmann Thomas, von Rundstedt Friedrich-Carl, Grimm Marc-Oliver, Teichgräber Ulf
Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Jena, Am Klinikum 1, 07747 Jena, Germany.
Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Jena, Am Klinikum 1, 07747 Jena, Germany.
J Vasc Interv Radiol. 2018 Aug;29(8):1127-1137. doi: 10.1016/j.jvir.2018.03.014. Epub 2018 Jun 15.
To evaluate clinical outcomes and possible MR imaging predictors of clinical success after prostatic artery embolization (PAE) with 250-μm hydrogel particles.
During a span of 1.5 years, 30 patients with moderate to severe lower urinary tract symptoms were included in a prospective, nonrandomized study. Embolization of at least one prostatic artery was considered as technical success. International Prostate Symptom Score (IPSS), quality of life (QOL), peak urinary flow rate (Q), residual urine volume, prostate volume, prostate-specific antigen level, and International Index of Erectile Function (IIEF) were recorded at baseline and at 1, 3, and 6 months after PAE. Multiparametric MR imaging was performed before PAE (n = 25) and 1 day (n = 25), 1 month (n = 7), 3 months (n = 7), and 6 months (n = 22) after intervention. A Wilcoxon-Mann-Whitney test was used to assess changes over time, and Spearman rank-correlation coefficient was used for outcome prediction.
PAE was technically successful in 90% of patients (n = 27). Clinical success (IPSS < 18 with decrease > 25% and QOL score < 4 with decrease ≥ 1 or Q ≥ 15 mL/s and increase of ≥ 3.0 mL/s) rates were 59% (16 of 27), 63% (17 of 27), and 74% (20 of 27) after 1, 3, and 6 mo, respectively. IIEF scores did not differ significantly during follow-up. The following adverse events occurred after PAE: urethral burning (5 of 27), fever (2 of 27), and urethral bleeding, rectal bleeding, cystitis, and penile burning sensation (1 of 27 each). No statistical correlations between initial multiparametric MR imaging changes and clinical parameters after 6 months were found (P values from .14 to .98).
PAE with 250-μm hydrogel microspheres led to good clinical success after 6 months with a low complication rate. Significant MR imaging predictors of clinical success were not identified.
评估使用250μm水凝胶颗粒进行前列腺动脉栓塞术（PAE）后的临床疗效以及临床成功的可能磁共振成像预测因素。
在1.5年的时间里，30例中重度下尿路症状患者纳入一项前瞻性、非随机研究。至少一条前列腺动脉栓塞成功视为技术成功。在基线以及PAE后1、3和6个月记录国际前列腺症状评分（IPSS）、生活质量（QOL）、最大尿流率（Q）、残余尿量、前列腺体积、前列腺特异性抗原水平以及国际勃起功能指数（IIEF）。在PAE前（n = 25）以及干预后1天（n = 25）、1个月（n = 7）、3个月（n = 7）和6个月（n = 22）进行多参数磁共振成像。采用Wilcoxon-Mann-Whitney检验评估随时间的变化，采用Spearman等级相关系数进行疗效预测。
90%的患者（n = 27）PAE技术成功。1、3和6个月后的临床成功率（IPSS < 18且下降> 25%，QOL评分< 4且下降≥ 1或Q≥ 15 mL/s且增加≥ 3.0 mL/s）分别为59%（27例中的16例）、63%（27例中的17例）和74%（27例中的20例）。随访期间IIEF评分无显著差异。PAE后发生以下不良事件：尿道烧灼感（27例中的5例）、发热（27例中的2例）以及尿道出血、直肠出血、膀胱炎和阴茎烧灼感（各27例中的1例）。未发现初始多参数磁共振成像变化与6个月后的临床参数之间存在统计学相关性（P值范围为0.14至0.98）。
使用250μm水凝胶微球进行PAE在6个月后临床疗效良好，并发症发生率低。未发现临床成功的显著磁共振成像预测因素。
