子宫动脉造影解剖分析及对栓塞治疗子宫肌瘤的指导意义  

The significance of characteristic angiographic uterine artery anatomy for uterine fibroid artery embolization

作　　者：梁志会[1] 崔进国[1] 潘新元[1] 周桂芬[1] 任美杰[1] 田惠琴[1] 应建伟[1] 

机构地区：[1]河北石家庄白求恩国际和平医院放射科,050082

出　　处：《介入放射学杂志》2005年第1期51-53,共3页Journal of Interventional Radiology

摘　　要：目的　研究子宫肌瘤血管造影表现特点及其临床价值。方法　 75例患者 ,经临床症状 ,彩超和 (或 )CT检查确诊子宫肌瘤 ,其中黏膜下肌瘤 9例 ,肌壁间肌瘤 5 0例 ,浆膜下肌瘤 16例 ;单发肌瘤 2 1例 ,多发肌瘤 5 4例。经右侧股动脉穿刺插管 ,导管分别插入双侧子宫动脉造影 ,观察内容包括 :子宫动脉的起源及其分支、不同类型子宫肌瘤的血管造影表现 ,然后进行栓塞治疗。结果　①大多数患者子宫动脉大部分发自髂内动脉的臀下动脉阴部干 ,其次为髂内动脉主干和臀上动脉。②子宫肌瘤供血情况分为 :a、一侧子宫动脉供血为主型。b、双侧子宫动脉均衡供血型。c、单纯一侧子宫动脉供血型。③卵巢支的栓塞几乎不可避免 ,其临床后果仍存在争议。结论　子宫动脉栓塞是治疗子宫肌瘤的一种安全有效的方法 ,熟悉子宫肌瘤的血管解剖对提高技术成功率、合理选用栓塞方法有重要意义。Objective To study the angiographic characteristics of uterine fibroid and evaluate its clinical significance.Methods The diagnosis of 75 patients was assumed by clinical symptoms, color Doppler ultrasound and/or CT imaging. Among them, the sites of fibroids were 9 under mucous membrans, 50 in the myometrium, 16 under serous membrane. After puncture the right femoral artery followed by angiography of bilateral uterine arteries, the origin of the uterine artery with its branches especially the ovarin arteries was demonstrated including the angiographic characteristics of uterine fibroids of different types were clearly shown. Then UAE was undertaken. Results 1. most of the uterine arteries were originated from the trunk of inferior gluteal and internal pudendal artery and less from the internal iliac artery and superior gluteal artery. 2. the blood supply of the neoplasm was classified by: ① from both uterine arteries equally; ② mainly from one uterine artery; ③ simply from one uterine artery. 3. the ovarian artery may be embolized inevitably, and its clinical effects need further evaluation. Conclusions Treating the uterine fibroid by embolization of uterine artery is an effective method. Being familiar with the local angiographic anatomy is of great importance for improving the successful rate and choosing the method reasonably.

关 键 词：子宫肌瘤 子宫动脉造影 供血 栓塞治疗 双侧 髂内动脉 血管造影 患者 血型 解剖 

分 类 号：R737.33[医药卫生—肿瘤]