Cerrahpasa Medical Faculty, Radiology Department, Istanbul University, Istanbul, Turkey.
Obstetrics and Gynecology Department, Yeni Yüzyıl University Gaziosmanpaşa Hospital, Istanbul, Turkey.
J Ultrasound Med. 2021 Dec;40(12):2607-2615. doi: 10.1002/jum.15647. Epub 2021 Feb 18.
We aimed to determine if superb microvascular imaging (SMI) can predict response to uterine artery embolization (UAE) as compared with power Doppler ultrasound.
The blood flow and the volume of the dominant leiomyoma was evaluated by power Doppler ultrasonography (PDUS) and SMI 1 day before and 3 months after the UAE procedure. SMI and PDUS blood flow were classified to 4 grades of vascularity. The change in fibroid volume in Grades 0-2 (hypovascular group) was compared to the hypervascular Grade 3 group.
Twenty-eight women (mean age, 40.9 years; range, 33-53 years) were examined with PDUS and SMI before and 3 months after UAE. The volume reduction was statistically significantly higher hypervascular group (P < .05). When we accept 30% or more volume reduction as a good response to UAE, the positive predictive value, negative predictive value, sensitivity, specificity, and accuracy of SMI were 100, 64, 73.6, 100, and 82.1%, respectively. There was excellent agreement between the two blinded observers in SMI measurements.
SMI, with its high reproducibility, provides further microvessel information than PDUS in uterine fibroids. It may be a useful tool in prediction of response to UAE treatment and improve counseling and patient selection for UAE versus medical or surgical treatment options.
与功率多普勒超声相比，我们旨在确定超级微血管成像（SMI）是否可以预测子宫动脉栓塞术（UAE）的反应。
在 UAE 术前 1 天和术后 3 个月，通过功率多普勒超声（PDUS）和 SMI 评估主导肌瘤的血流和体积。将 SMI 和 PDUS 血流分为 4 级血管化程度。比较 0-2 级（低血管组）和 3 级（高血管组）的肌瘤体积变化。
28 名女性（平均年龄 40.9 岁；范围 33-53 岁）接受了 UAE 术前和术后 3 个月的 PDUS 和 SMI 检查。高血管组的体积减少具有统计学意义（P <.05）。当我们接受 30%或更多的体积减少作为 UAE 的良好反应时，SMI 的阳性预测值、阴性预测值、敏感性、特异性和准确性分别为 100、64、73.6、100 和 82.1%。在 SMI 测量方面，两位盲法观察者之间存在极好的一致性。
SMI 具有较高的可重复性，比 PDUS 提供了更多的子宫纤维瘤微血管信息。它可能是预测 UAE 治疗反应的有用工具，并改善 UAE 与药物或手术治疗选择的咨询和患者选择。
