子宫肌瘤的血管造影表现及其临床意义  

Angiographic findings and their significance of uterine myomas

作　　者：杜娟[1] 左约维[1] 陈晓明[2] 胡小平[1] 李勇[2] 陆骊工[2] 胡宝山[2] 庄文行[2] 罗鹏飞[2] 洪淡华[1] 

机构地区：[1]广东省人民医院妇产科,广东广州510080 [2]广东省人民医院介入治疗科,广东广州510080

出　　处：《中国基层医药》2005年第2期195-196,共2页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省卫生厅高难;高新技术项目(C2000031);广东省医学科研课题(A2001065)

摘　　要：目的探讨子宫肌瘤的血管造影表现及其在诊断与介入治疗中的价值。方法198例子宫肌瘤患者接受子宫动脉数字减影血管造影(DSA)检查,观察子宫动脉走行、分布、血供程度、肌瘤表现和特点等。结果198例均为富血型,按子宫动脉供血范围或比例不同可分为一侧供血为主型(591%)、双侧对称供血型(328%)及单纯一侧供血型(81%)。子宫动脉卵巢支或(和)卵巢动脉显影96例,占485%。肌瘤的典型表现是动脉早期子宫动脉分支在肌瘤表面呈弧形分布的粗大的外层血管网和动脉晚期外层血管网分出的细小分支伸入肌瘤内形成内层血管网。结论内外层血管网表现是鉴别子宫肌瘤与子宫腺肌瘤的重要征象;子宫肌瘤的DSA表现对子宫肌瘤的栓塞治疗具有重要指导意义。Objective To evaluate the angiographic findings of uterine myomas and their values in the diagnosis and interventional treatment of uterine myomas.Methods Digital subtraction anglography(DSA) of uterine artery was performed in 198 patients with uterine myomas before they underwent transcatheter uterine artery embolization(TUAE).Angiographic findings including distribution of uterine artery,blood supply and DSA feature of uterine myomas were observed and analysed.Results Blood supply of myomas was found to be hypervascular in all 198 patients.According to the distribution of uterine artery flow,3 types of blood supply were identified.In type Ⅰ,blood supply of myomas came from unilateral uterine artery mostly in 59.1%(117/198);in type Ⅱ,blood supply came from bilateral uterine artery symmetrically in 32.8%(65/198);in type Ⅲ, blood supply came from unilateral uterine artery completely in 8.1%(16/198).Ramus ovaricus arterial uterine orland ovarian artery were visualized in 96 patients(48.5%).The characteristic finding included outer vascular net consisted of branches of uterine artery on the surface of myomas in early artery phase and inside vascular net consisted of arterioles from outer vascular net into myomas in later artery phase.Conclusions The outer and insider vascular net of uterine myomas is the most important sign differentiated from adenomyosis.DSA findings of uterine myomas have an important role in interventional treatment of uterine myomas.

关 键 词：子宫肌瘤 子宫动脉 血管造影 供血 血管网 临床意义 诊断 结论 指导意义 比例 

分 类 号：R737.33[医药卫生—肿瘤]