Haemodynamic Changes Of Uterus And Fibroid Before And After Uterine Artery Embolization And Clinical Application

Part one: Haemodynamic Changes of Uterus and Fibroid before and after Uterine Artery EmbolizationObjective: To evaluate haemodynamic features of the uterus and the fibroid before and after uterine artery embolization(UAE).Materials and Methods: 16 symptomatic cases with single uterine fibroid were treated by selective bilateral uterine artery embolization. The slices at or near the largest fibroid area were selected for dynamic CT scans. The selected slice must include both fibroid and uterine tissue. Scanning parameters included: 120-160KV, 180mA, scan interval=5 seconds, number of scans/patient=20, slice thick=10mm. Antecubital injection of nonionic contrast media was carried out with the amount of 2ml/kg and the injection speed of 2.5ml/s. Dynamic CT scans were performed before UAE,5-7 days after UAE and 3-5 months after UAE in all cases. The patients breathed with thoracic respiration and were depressed with abdominal bandage in the course of scans.The CT values within specific regions of uterus and fibroid on dynamic CT scans weremeasured. Self-controlled analyses were performed for these CT values and the time-density curves of specific regions were drawn in order to observe hemodynamic changes of uterus and fibroidResults: Dynamic CT scans were successful in all 16 cases.There was no significant difference for the CT values of the uterus tissue (p>0.05). However, the CT values of fibroids were significant difference between scans before UAE and scans 5-7days after UAE (p<0.05), and between scans before UAE and scans 3-5 months after UAE (p<0.05). Similar changes were revealed in the time-dentity curves of specific regions in uterus before UAE and in 5-7days,3-5 months after UAE. The time-dentity curves of specific regions in fibroid were in a state of low and level after UAE.Conclusion: Blood supply of the fibroids could be significantly and persistently obliterated by UAE with less impact on blood supply of uterus. UAE is safe and effective in treating fibroids according to the our short term follow-up observation in limited cases.Part two Clinical Application of Fibroid Treated with Uterine Artery EmbolizationObjective: To investigate the curative effects and to analyze the mechanism, side effects and complications of UAE.Materials and Methods: 32 cases with symptomatic uterine fibroidwere treated by bilateral uterine artery embolization. Follow-up was conducted according to the amount of menstruation, duration of menstruation, status of anemia and the size of the uterus and the treated fibroids.Results: The amount of menstruation decreased distinctly. Duration of menstruation also shortened significantly. Anemia was corrected 3-5 months after the treatment. The average volume of uterus and fibroid decreased 38.4%, 42.4% in3-5 months, 48.5%, 56.8% in 6-9 months after UAE.There was significant difference for these changes before and after UAE(p<0.05).Conclusion Selective uterine artery embolization is safe and effective with less invasion in the treatment of uterine fibroids.