The Application Of Uterine Artery Embolization Treatment Of Uterine Fibroids Anatomy Study

Objective:We observe the origin, courser, branch and disposition of uterine artery to provide the clinical anatomical foundation for uterine artery embolization.Method:To analyze the pelvic contrast-enhanced MRI of30cases of normal women of childbearing age (A group) and30cases of uterine fibroids (B group), we study the branch and courser of uterine artery.(1) the number and origin of uterine artery.(2) the internal diameter of the initial segment of uterine artery and its branches.(3) the angle of both sides of common iliac artery and both sides of internal iliac artery, the angle between uterine artery and its bole.Results:(1) The sample of uterine arteries for this research are all have right and left branches, and sixty percent of them come from anterior branch of internal iliac arteries. Others may originate from the pudendal bole of the inferior gluteal artery, the pudendal artery and internal iliac artery.(2) the internal diameter of the uterine artery and its branches.. A group results:The internal diameter of the initial segment of uterine artery:Left2.75±0.39mm,Right2.60±0.41mm; the internal diameter of the main branches of uterine artery:①body branch:Left1.68±0.38mm, Right1.70±0.42mm;②bottom branch:Leftl.53±0.44mm, Right1.60±0.28mm;③ovarian tubes branch:Left1.33±0.36mm,Rightl.42±0.34mm;④ovarian branch:Left2.10±0.58mm, Right2.15±0.36mm. B group results:The internal diameter of the initial segment of uterine artery:Left3.91±0.15mm,Right3.32±0.16mm; the internal diameter of the main branches of uterine artery:①body branch:Left2.15±0.20mm,Right1.95±0.18mm;②bottom branch:Leftl.70±0.44mm, Right1.82±0.48mm;③ovarian tubes branch:Left1.31±0.34mm,Right1.52±0.38mm;④ovarian branch:Left2.50±0.38mm,Right2.30±0.48mm. Their internal diameter are no significant difference between A group and B group (P>0.05). Ovarian branch of uterine artery is the widest branch.(3) the angle between uterine artery and its bole:acute angle are48cases, occupy of68.5%(left25cases, right23cases); right angle are15cases, occupy of21.4%(left in7cases, right8cases); obtuse angle are7cases, occupy of10%(left3cases, right4cases). The angle of both sides of common iliac artery is78.0±3.0°, the angle of both sides of internal iliac artery is41.0±4.0, the angle between uterine artery and its bole is44.0±6.0°.Conclusion:(1) The uterine artery and its bottom branch of the patients suffered from uterine fibroids are wider than those of normal females, the blood supply may increasing because uterine fibroids increase volume of uterine.(2) Ovarian branch of uterine artery is the widest branch. We choose a larger embolic agent in clinic surgery to avoid to irreversibly damage the function of ovarian. When ovarian branch of uterine artery have developed, we must image opportunely and monitor the extent of embolism, we stop embolism when the artery of uterine fibroids have n’t developed. We put the head-end of microcatheter to the artery close to uterine to prevent the embolic agents into ovarian.(3) The angle between uterine artery and its bole is an acute angle mostly, success rate of microcatheter intubation is higher, so it is important of the angle between uterine artery and its bole to choose the kinds of catheter.(4) Because the angle of both sides internal iliac artery is smaller, if we intubate on both sides at the same time, the folding catheter may influence the embolic agent from the target organ, and even a larger embolic agent can block catheter to fail. This is the main reasons to choose intubation on other side in uterine artery embolization.