彩色多普勒超声评价子宫动脉栓塞治疗子宫肌瘤疗效的临床价值

Evaluation of effects of uterine artery embolization for uterine fibroid by color Doppler sonography

目的探讨彩色多普勒超声评价子宫动脉栓塞(uterine artery embolization, UAE)治疗子宫肌瘤临床效果的价值.方法有症状的子宫肌瘤23例,于栓塞术前和栓塞术后1～7 d、1～3个月、6～12个月,经阴道彩色多普勒超声检查,测量子宫和肌瘤的大小、肌瘤中心和周边动脉及子宫动脉的阻力指数(RI).结果栓塞术后1～7 d观察21例,7例子宫体积较术前增大10%(4%～ 63%),其余14例子宫体积缩小21%(1%～67%),肌瘤体积缩小24%(1%～56%);术后1～3个月观察21例,子宫和肌瘤体积分别缩小53%(24%～82%)和47%(6%～88%);术后6～12个月观察19例,子宫和肌瘤体积分别缩小66%(5%～91%)和71%(32%～99%).栓塞术后,肌瘤中心及周边血管明显减少或消失,栓塞术前后各期子宫动脉阻力指数(RI)的变化无统计学差异(F＝0.47, P=0.70).术后1年患者症状改善率达87%(20/23).结论子宫动脉栓塞治疗部分有症状的子宫肌瘤是安全和有效的,彩色多普勒超声可通过观察手术前后子宫肌瘤体积和子宫血流动力学变化评价UAE的疗效.

Objective To assess the clinical value of color doppler sonography in the evaluation of effects of uterine artery embolization （UAE） for the treatment of uterine fibroid. Methods Twenty - three patients with symptomatic uterine fibroid were given transvaginal color Doppler sonography before and 1 - 7 days, 1 - 3 months and 6 - 12 months after the UAE. Measurements of the uterus, myomas, and resistance index （RI） of the uterine artery were obtained. Results Out of 21 patients examined at 1 -7 days after UAE, the uterus volume increased by a mean of 10% in 7 patients （4% -63% ） and decreased by a mean of 21% in 14 patients （1% -67% ） with the dominant myoma decreased by 24% in size （1% -56% ）. In 21 patients examined at 1 -3 months after embolization, the uterus and dominant myoma decreased in size by 53% （24% -82% ） and 47% （6% -88% ） , respectively. In 19 patients examined at 6 - 12 months, the uterus and myoma decreased in size by 66% （5% -91% ） and 71% （32% -99% ） , respectively. Vessels inside and surrounding the myoma remarkably diminished or completely disappeared after embolization. No statistically significant changes in uterine artery RI were noted before and after UAE （ F = 0. 47, P = 0. 70）. Symptomatic improvements were achieved in 87% of patients （20/23） at 1 year after UAE. Conclusions UAE for the treatment of symptomatic uterine fibroid is safe and effective. Color Doppler sonography can evaluate the effect of UAE by means of measuring the volume of the uterus and myoma and the hemodynamic changes of the uterine artery before and after embolization.