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目的探讨彩色多普勒超声在子宫动脉栓塞术(UAE)治疗子宫肌瘤疗效评估中的作用。方法30例子宫肌瘤患者共42个肌瘤结节,在UAE术前1周内和术后10d及1年内每月定期进行超声检查,观察子宫及肌瘤的大小、形态以及内部回声与血流动力学状况,测量子宫动脉、肌瘤周边与内部血管的血流速度(VS),血流量(BFV),阻力指数(RI),搏动指数(PI)。结果UAE术前子宫平均体积491.37cm3,肌瘤平均体积102.33cm3,42个肌瘤结节中36个低回声,4个等回声,2个高回声,肌瘤周边有晕环,周边血流较丰富,内部血流较多。UAE术后,子宫平均体积236.75cm3,缩小51.82%(Ρ<0.01)。肌瘤平均体积48.87cm3,缩小52.24%(Ρ<0.01)。术后3个月肌瘤进行性缩小,随后趋于稳定。肌瘤内部从高回声逐渐减低,演变形成不均质的略高回声、等回声或低回声,未见液化腔。肌瘤周边晕环消失,回声逐渐增高,形成环状强回声,肌瘤内和肌瘤周边无血流显示,本组显效70%,有效10%,总有效率90%。结论彩色多普勒超声是评价UAE治疗子宫肌瘤疗效的有效方法。
Objective To investigate the role of color Doppler ultrasound in evaluating the efficacy of uterine fibroids in patients undergoing uterine artery embolization (UAE). Methods A total of 42 fibroid nodules were obtained from 30 patients with uterine fibroids. The uterus and fibroids were examined regularly by ultrasound examination within 1 week before UAE and 10 days and 1 year after operation respectively. The size, shape, Flow mechanics status, blood flow velocity (VS), blood flow (BFV), resistance index (RI) and pulsatility index (PI) of uterine artery, fibroids peripheral and internal vessels were measured. Results UAE average volume of 491.37cm3 uterus before surgery, the average volume of 102.33cm3 fibroids, 42 fibroids in 36 hypoechoic, 4 echogenic, 2 hyperechoic, fibroids around the halo, peripheral blood flow more Rich, more internal blood flow. UAE surgery, the average volume of 236.75cm3 uterus, reduced 51.82% (P <0.01). The average volume of fibroids was 48.87cm3, narrowing 52.24% (P <0.01). 3 months after fibroids shrinking, then stabilized. Fibroids within the gradual reduction from the high echo evolved into an inhomogeneous slightly higher echo, such as echo or hypoechoic, no liquefied cavity. Myoma peripheral halo disappears, echo gradually increased, forming a ring-shaped echo, fibroids and fibroids peripheral blood flow showed that this group markedly effective 70%, effective 10%, the total efficiency of 90%. Conclusion Color Doppler ultrasound is an effective method to evaluate the efficacy of UAE in the treatment of uterine fibroids.