Department of Interventional Radiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China.
Department of Diagnostic Radiology, Jiangxi Cancer Hospital, Nanchang, 330029, China.
Curr Med Sci. 2021 Dec;41(6):1252-1256. doi: 10.1007/s11596-021-2473-4. Epub 2021 Nov 28.
To investigate the association between magnetic resonance imaging (MRI) classification and symptom relief after uterine artery embolization (UAE) in patients with adenomyosis.
Totally, 73 patients with symptomatic adenomyosis who underwent UAE were retrospectively analyzed. Preoperative MRI classification was defined as: type I, high signal on both T2-weighted images (T2WI) and T1-weighted images (T1WI); type III, high signal only on T2WI, and type II, high signal on neither T1WI nor T2WI. Dysmenorrhea was measured with the visual-analog scales and the degree of menorrhagia was measured according to the number of sanitary pads used in one menstrual cycle. Dysmenorrhea and menorrhagia were measured before UAE and 12 months after UAE.
The number of the type I, II, III cases was 23, 37, and 13, respectively. The baseline characteristics of the three groups exhibited no significant difference. The alleviation rates of dysmenorrhea among type I, II, III cases were 73.9%, 89.2%, and 84.6%, respectively (P=0.455). The alleviation rates of menorrhagia for type I, II, III were 69.6%, 78.4%, and 92.3%, respectively (P=0.714).
Pre-procedure MRI classification and symptom relief after UAE exhibited no significant association. UAE has a favorable mid-term control on dysmenorrhea and menorrhagia among patients with adenomyosis. Preoperative MRI classification might not indicate symptom relief. More research is needed before changing clinical practice.
探讨磁共振成像（MRI）分类与子宫动脉栓塞术（UAE）后子宫腺肌病患者症状缓解之间的关系。
回顾性分析了 73 例接受 UAE 治疗的有症状子宫腺肌病患者。术前 MRI 分类定义为：I 型，T2 加权图像（T2WI）和 T1 加权图像（T1WI）均呈高信号；III 型，仅 T2WI 呈高信号，II 型，T1WI 和 T2WI 均无高信号。痛经采用视觉模拟评分法（VAS）测量，月经过多程度根据一个月经周期使用的卫生棉条数量来衡量。在 UAE 前和 UAE 后 12 个月测量痛经和月经过多。
I 型、II 型、III 型的例数分别为 23、37 和 13。三组的基线特征无显著差异。I 型、II 型、III 型痛经缓解率分别为 73.9%、89.2%和 84.6%（P=0.455）。I 型、II 型、III 型月经过多缓解率分别为 69.6%、78.4%和 92.3%（P=0.714）。
术前 MRI 分类与 UAE 后症状缓解无显著相关性。UAE 对子宫腺肌病患者的痛经和月经过多具有良好的中期控制作用。术前 MRI 分类可能无法预示症状缓解。在改变临床实践之前，还需要更多的研究。
