Nocum Don J, Robinson John, Liang Eisen, Thompson Nadine, Reed Warren
San Radiology & Nuclear Medicine, Sydney Adventist Hospital, Wahroonga, New South Wales, Australia.
Faculty of Health Sciences, School of Medical Radiation Sciences, University of Sydney, Cumberland, New South Wales, Australia.
J Med Radiat Sci. 2019 Sep;66(3):200-211. doi: 10.1002/jmrs.347. Epub 2019 Jul 22.
Uterine artery embolisation (UAE) is an interventional angiography procedure for the treatment of symptomatic fibroids and/or adenomyosis in women. UAE is a less invasive and non-surgical alternative to hysterectomy or myomectomy. However, ionising radiation is used for both fluoroscopic and angiographic image guidance to visualise and access the uterine arteries for embolisation and treatment of these benign conditions. Identifying the contributors and implementing dose reduction techniques are particularly important as UAE patients are usually of child-bearing age. The purpose of this review was to examine the progression of literature on radiation exposure measurements and identifying the factors contributing to the total radiation exposure of female patients undergoing UAE. A Medline, ProQuest Central, ScienceDirect and Scopus database search from 2000 to 2018 was performed and forty articles were deemed acceptable for review following the inclusion and exclusion criteria set. UAE is a viable alternative to hysterectomy and myomectomy, as the reviewed literature demonstrated that the reported radiation exposure doses appear to be below the threshold for any deterministic radiation risks. The total radiation exposure of UAE patients is affected independently by multiple patient, operator expertise and technique, angiographic imaging and x-ray unit variables. Uterus preservation can be attained post-UAE with dose reduction and optimisation, however, a longitudinal study on UAE patients and their risk of radiation-induced deterministic and/or stochastic effects is recommended.
子宫动脉栓塞术（UAE）是一种用于治疗女性症状性子宫肌瘤和/或子宫腺肌病的介入血管造影手术。UAE是子宫切除术或肌瘤切除术的一种侵入性较小的非手术替代方法。然而，在透视和血管造影图像引导中均使用了电离辐射，以可视化并进入子宫动脉，从而栓塞和治疗这些良性疾病。由于UAE患者通常处于育龄期，因此确定辐射源并实施剂量降低技术尤为重要。本综述的目的是研究关于辐射暴露测量的文献进展，并确定导致接受UAE的女性患者总辐射暴露的因素。我们对2000年至2018年的Medline、ProQuest Central、ScienceDirect和Scopus数据库进行了检索，按照设定的纳入和排除标准，有40篇文章被认为可接受综述。UAE是子宫切除术和肌瘤切除术的一种可行替代方法，因为综述文献表明，所报告的辐射暴露剂量似乎低于任何确定性辐射风险的阈值。UAE患者的总辐射暴露受到多种患者、操作者专业知识和技术、血管造影成像以及X射线设备变量的独立影响。通过降低剂量和优化，UAE术后可保留子宫，然而，建议对UAE患者及其辐射诱发的确定性和/或随机效应风险进行纵向研究。
