Department of Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Department of Nuclear Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
J Obstet Gynaecol. 2024 Dec;44(1):2372645. doi: 10.1080/01443615.2024.2372645. Epub 2024 Jun 29.
This study examined the improvement of dysmenorrhoea and menorrhagia after uterine artery embolisation (UAE) in women with symptomatic adenomyosis and identified factors that could predict the improvement of dysmenorrhoea and menorrhagia.
This retrospective study included women with adenomyosis who underwent bilateral UAE between December 2014 and December 2016. The percentage of the volume of the absence of contrast enhancement on T1-weighted images was evaluated 5-7 days after UAE. A receiver operating characteristic (ROC) analysis was used to determine a cut-off point and predict the improvement of dysmenorrhoea and menorrhagia.
Forty-eight patients were included. At 24 and 36 months after UAE, the improvement rates for dysmenorrhoea and menorrhagia were 60.4% (29/48) and 85.7% (30/35), and the recurrence rates were 19.4% (7/36) and 9.1% (3/33), respectively. Only the percentage of the volume of the absence of contrast enhancement on T1-weighted images was associated with the improvement of dysmenorrhoea (=0.001, OR = 1.051; 95% CI: 1.02-1.08) and menorrhagia (=0.006, OR = 1.077; 95% CI: 1.021-1.136). When the cut-off value of the ROC analysis was 73.1%, sensitivity, specificity, positive predictive value, and negative predictive value for the improvement of dysmenorrhoea were 58.6%, 94.7%, 94.4%, and 60%, while they were 58.9%, 80%, 100%, 100%, and 45.5% for the improvement of dysmenorrhoea.
Bilateral UAE for symptomatic adenomyosis led to good improvement of dysmenorrhoea and menorrhagia. The percentage of the volume of the absence of contrast enhancement on T1-weighted images of the uterus in postoperative magnetic resonance imaging might be associated with the improvement of dysmenorrhoea and menorrhagia.
本研究旨在探讨子宫动脉栓塞术（UAE）治疗症状性子宫腺肌病后痛经和月经过多的改善情况，并确定预测痛经和月经过多改善的因素。
本回顾性研究纳入了 2014 年 12 月至 2016 年 12 月期间接受双侧 UAE 的子宫腺肌病患者。UAE 后 5-7 天，采用 T1 加权图像上无强化区域的体积百分比评估。采用受试者工作特征（ROC）分析确定截断值，并预测痛经和月经过多的改善情况。
本研究共纳入 48 例患者。UAE 后 24 个月和 36 个月时，痛经的改善率分别为 60.4%（29/48）和 85.7%（30/35），痛经复发率分别为 19.4%（7/36）和 9.1%（3/33）。只有 T1 加权图像上无强化区域的体积百分比与痛经的改善相关（=0.001，OR=1.051；95%CI：1.02-1.08）和月经过多（=0.006，OR=1.077；95%CI：1.021-1.136）。ROC 分析的截断值为 73.1%时，痛经改善的敏感性、特异性、阳性预测值和阴性预测值分别为 58.6%、94.7%、94.4%和 60%，而痛经改善的敏感性、特异性、阳性预测值和阴性预测值分别为 58.9%、80%、100%、100%和 45.5%。
双侧 UAE 治疗症状性子宫腺肌病可显著改善痛经和月经过多。术后磁共振成像上子宫 T1 加权图像上无强化区域的体积百分比可能与痛经和月经过多的改善有关。
