PrefaceUterine myoma is a disease commonly seen in gynecology. The traditional methods used to treat symptomatic uterine myoma include hormone therapy, myomectomy and hysterectomy, but each of the methods has certain defects.Uterine artery embolization ( UAE) is a newly developed method used to treat uterine myoma. Since 1995, there have been many associated reports inland and abroad. MRI and ultrasound are the two main radiological tools used before and after UAE. MRI is preferred in overseas. They help to make diagnosis for myoma before operation and compare the size and volume of myoma and uterus pre - operation and post - operation. But there is a little of report about the change of blood flow in myoma after embolization. In this study, color Doppler ultrasound was used to follow up the patients who underwent UAE and we discussed the characteristic of the change of blood flow after embolization, its correlation with the change of myoma volume and the practical value of color Doppler ultrasound in observing the curative effect of UAE for uterine myoma.Patients and Methods1. Patients:We randomly selected 29 patients with uterine myoma who underwent UAE therapy. These patients were 29 to 55 years old ( mean age: 42. 6 years old) . All of them had hypermenorrhea, menstruation disturbance, anemia or abdominal pain. The final diagnosis of uterine myoma were made by Gynecologic doctors and other gynecologic diseases were excluded.2. Equipments and methods;All the patients had underwent Color Doppler ultrasonography before UAE using ATL - HDI 5000 or GE - LOGIQ 700 with convex or transvaginal probes. In each case, we measured the size of myoma (the three dimensions: D1, D2 and D3. If there were multiple myo-mas, we mainly measured the largest one or two) and recorded the location and echo of them. Color Doppler Energy (CDE) were used to observe the vascular distribution inside the myoma and at its peripheral areas. The pattern of blood flow in myoma was graded as follows; Pattern 0-presence of no blood flow. Pattern I -presence of sparse blood flow. Pattern II -presence of moderate blood flow. Pattern III-presence of abundant blood flow. Pulsed Doppler was used to test the PSV, EDV and RI of myoma artery. All the patients were followed up by ultrasonography 1 week, 3 months, 6 months after operation. The indexes above were all respectively recorded.The chang of myoma in volume was analyzed by paired t - test; The change in blood flow was analyzed by rank sum test. The relationship between the chang of myoma in volume and in blood flow wasstudied by using Spearman rank correlation coefficent.Results1. sonographical results before operation;32 myomas were included in this study, whose volume was 10. 9 - 364. 5cm3 ( mean volume 100. 18cm3). all the myomas were hypoe-choic or echogenetic nodes with distinct margin. CDE showed the blood flow pattern of myoma, in which pattern III 13 cases, pattern II 17 cases, pattern I 2 cases and pattern 0 no case. Myoma with abundant or moderate blood flow ( pattern III + pattern II ) occupied 93. 75% of all cases. Before operation, PSV of Myoma artery was 18. 83 10.9cm/s, EDV was 8.03 5.75cm/s, RI was 0.61 0.18.2. Following - up after operation(1) Change of the myoma volume: 1 week after embolization, there was no significant difference between pre - operation and post -operation in the volume of the 12 myomas (p >0.05) , whose volume decreased by 4. 77% ; while there was significant difference after 3 months and 6 months ( p <0. 01). The volume decreased by 50. 06% after 3 months and 63. 7% after 6 months.(2 ) Change of blood flow in myoma: The blood flow of the myoma decreased significantly and even diseapeared after embolization ( p <0. 01 ). The sparse or disappeared type of blood flow 1 week, 3 months and 6 months after embolization was respectively 83. 33% , 86.36% and 77.78%.(3.) The relationship between the change of volume and the change of blood flow: Spearman rank correlation analysis showed that the decrease in... |