Imaging Evaluation Of UAE In The Treatment Of Uterine Fibroids

Objective:To investigate the clinical efficacy of Uterine Artery Embolization(UAE)in the treatment of uterine fibroids and the imaging evaluation of the efficacy of ultrasound and magnetic resonance imaging(MRI).Methods:Subjects selected 51 patients with uterine fibroids admitted in our hospital between June 2015 and June 2016.All patients were given symptomatic support after admission and treated with UAE under conditions consistent with surgical indications.Before and after treatment,the patients were examined by ultrasonography and MRI.The patients were examined by digital subtraction angiography(DSA).The incidence of thick blood supply arteries,tumor capsule and inner and outer vessel network were observed.After the end of treatment,patients were followed up for 1 year and the total effective rate of UAE treatment was calculated according to the remission of clinical symptoms.The menstrual condition and hormone level were examined and compared with preoperative.At the time of follow-up,all patients underwent ultrasound and MRI examination.Ultrasonography showed changes in blood flow,echo and volume of the tumor.MRI was also performed on the T1WI and T2WI signals of the patients before and after surgery,as well as the volume of the fibroids before and after treatment.All patients were followed up for clinical symptoms during follow-up and recorded their postoperative complications.Results:In the 51 patients,the embolization of the patients was more successful.The DSA images showed that 36(70.59%)patients had thick arterial arteries in patients with uterine leiomyoma,22(43.14%)patients had tumor capsule,38(74.51%)Patients with internal and external vascular network development.Fifty one patients with UAE treatment were successfully completed,1 year after follow-up of its volume and tumor volume evaluation and division of efficacy level showed that 25(49.02%)patients with 1 year after the efficacy evaluation was marked,17(33.33%)patients 1 year after the evaluation of efficacy is effective,9(17.65%)patients with significant amount of disorder or tumor volume progress and evaluation was invalid,the total effective rate was 82.35%.The mean menstrual cycle was(25.21±3.65)d before treatment,and which was(26.98±4.11)d at 1 year after treatment,and the difference was statistically significant(t=2.30,P=0.02).The mean menstrual period was(12.51±4.37)d before treatment,and which was(6.27±3.42)d at 1 year after treatment,the difference was statistically significant(t=8.03,P=0.00).The mean VAS score was(3.44±2.24)before treatment,and which was(1.15±0.46)at 1 year after treatment,the difference was statistically significant(t=7.15,P=0.00).The average amount of patients before treatment was(33.35±4.58)tablets,which was significantly higher than(9.63±2.27)tablets after treatment(t=33.14,P=0.00),43(84.31%)patients were recovery normal after UAE,5 patients had menstrual flow decrease.The level of LH and FSH of patients at three and six months after treatment was significantly higher than that before treatment,and the level of E2 was significantly lower than that before treatment(P<0.05).After 9 and12 months,LH,FSH and E2 level were not statistically significant(P>0.05).UAE preoperative examination of patients by color Doppler ultrasound imaging showed that the peripheral blood flow signal around the fibroids.At three months after treatment,the blood flow signal around uterine fibroids was disappeared in 51 cases,with pelvic venous plexus and muscle blood supply returning to normal.During the follow-up period of one year,two patients showed a sparse point-like blood flow signal in six months and twelve months,respectively;both patients underwent surgical resection based on MR imaging.UAE Patients at three months review can be seen annular low echo disappeared,the echo signal was uneven;postoperative review at six months showed four patients had a complete circular calcification,13 patients with semi-circular calcification;postoperative follow-up at 1 year,2 cases with sparse point blood flow signal had not calcification.Preoperative ultrasonographic evaluation site showed that the volume of fibroid was(55.36±13.52)cm~3.After UAE operation,the volume was(38.61±13.10)cm3 and the reduction rate was(25.69±16.22)%at 3-month follow-up,which was(28.56±10.16)cm3 and the reduction rate was(36.22±20.20)%at 6-month follow-up,the volume was(22.17±19.52)cm~3 and the reduction rate was(39.56±22.10)%at 9months,the volume was(15.17±9.27)cm~3 and the reduction rate was(42.96±19.56)%at 12 months.Postoperative tumor volume was significantly reduced at 3,6,9 and 12months compared with that before surgery,and the difference was statistically significant(P<0.05).MRI examinationshowed that the preoperative tumor volume of fibroid was(50.35±10.36)cm~3 before UAE.Which was(32.27±8.44)cm~3 and the reduction rate was(31.28±15.71)%at 3 months after operation,the volume was(21.43±7.98)cm~3 and the reduction rate was(40.35±16.83)%at 6 months after surgery,the volume was(15.72±7.59)cm~3 and the reduction rate was 43.28±21.35]%at 9 months after surgery,which was(11.18±7.52)cm~3 and the reduction rate was(45.12±20.56)%at 12 months after surgery.The mean tumor volume of the patients at 3,6,9 and 12 months after surgery was significantly lower than that before surgery,and the difference was statistically significant(P<0.05).Comparing the tumor volume of the patient's ultrasound examination with the results of MRI examination,it was found that the tumor volume detected by MRI was significantly smaller than that by ultrasound examination(P<0.05).MRI showed high signal myoma iso-intensity in 48(94.12%)cases and low signal3(5.88%)cases in the preoperative on T1WI,which was high signal in 44(86.27%)cases and iso-signal in 7(13.73%)cases at 1 year after treatment,the difference was significantly(P<0.05).However,there was no significant difference before and after treatment in signal of fibroids on T2WI(P>0.05).Conclusion:UAE treatment of uterine fibroids has significantly clinical efficacy,can effectively improve the clinical symptoms during menstruation,postoperative ultrasound and MRI examination showed a significant reduction in tumor volume,the two detection methods can effectively evaluate the clinical efficacy of uterine fibroids,Doppler ultrasonography can effectively observe the peripheral blood flow of fibroids.