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磁共振灌注参数和患者问卷对子宫肌瘤栓塞术的长期评估:初步结果。

Long-term evaluation of uterine fibroid embolisation using MRI perfusion parameters and patient questionnaires: preliminary results.

机构信息

Clinic for Radiology and Nuclear Medicine, University Medical Centre Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Department for Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

出版信息

BMC Med Imaging. 2022 Dec 5;22(1):214. doi: 10.1186/s12880-022-00926-y.

Abstract

BACKGROUND

Uterine fibroid embolisation (UFE) is an established treatment method for symptomatic uterine myomas. This study evaluates the efficacy of UFE using objective magnetic resonance imaging (MRI) data for size and perfusion analysis as well as patient questionnaires assessing fibroid-related symptoms.

METHOD

Patients underwent MR-Angiography before UFE and 4 days, 6 and 12 months after the procedure. The images were evaluated using dedicated software. Patient questionnaires were completed before UFE and at 12 months follow-up, focussing on the embolization procedure and symptoms associated with uterine fibroids. Statistical analysis of the questionnaires was performed using paired sample t-test and Wilcoxon signed rank test, while Kruskal-Wallis test and Friedman test were applied for MRI-analysis.

RESULTS

Eleven women were included. There was a significant reduction in fibroid-related symptoms. The volume reduction after 12 months was significant in both, uterus and myomas, after an initial increase in uterine volume at the first post-interventional MRI. The perfusion analysis showed that blood flow to the fibroids could be significantly reduced up to 12 months after UFE while uterine tissue was not affected.

CONCLUSION

This study shows that uterine fibroid embolisation induces a significant long-term decrease in myoma size and perfusion while healthy uterine tissue remains unaffected. Fibroid-related symptoms are reduced for the sake of improved quality of life.

摘要

背景

子宫肌瘤栓塞术(UFE)是一种成熟的治疗有症状子宫肌瘤的方法。本研究通过对大小和灌注进行客观磁共振成像(MRI)数据分析,以及评估与肌瘤相关症状的患者问卷,来评估 UFE 的疗效。

方法

患者在 UFE 前和术后 4 天、6 个月和 12 个月进行磁共振血管造影。使用专用软件评估图像。患者在 UFE 前和 12 个月的随访时完成问卷,重点关注栓塞程序和与子宫肌瘤相关的症状。使用配对样本 t 检验和 Wilcoxon 符号秩检验对问卷进行统计分析,而 MRI 分析则应用 Kruskal-Wallis 检验和 Friedman 检验。

结果

11 名女性被纳入研究。与子宫肌瘤相关的症状显著减轻。子宫和肌瘤的体积在 12 个月后均有显著减少,而在第一次介入后 MRI 中子宫体积最初增加。灌注分析显示,在 UFE 后 12 个月内,肌瘤的血流可以显著减少,而子宫组织不受影响。

结论

本研究表明,子宫肌瘤栓塞术可显著减少肌瘤大小和灌注,同时不影响健康的子宫组织。为了提高生活质量,与肌瘤相关的症状会减轻。

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