子宫肌瘤血管造影特点及对栓塞治疗的意义  

The Angiography Features of Angiography of Uterine Fibroid and its Significance for Uterine Artery Embolization

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

机构地区：[1]石家庄白求恩国际和平医院放射科,050082

出　　处：《临床放射学杂志》2005年第2期154-156,共3页Journal of Clinical Radiology

摘　　要：目的　研究子宫肌瘤血管造影表现特点及对栓塞治疗的意义。 资料与方法　本组75例,其中黏膜下肌瘤9例,肌壁间肌瘤50例,浆膜下肌瘤16例。单发肌瘤21例,多发肌瘤54例。局麻下采用Seldinger技术经右侧股动脉穿刺插管,应用5F Cobra导管分别插入双侧子宫动脉造影,观察子宫肌瘤供血动脉、肌瘤的血管网及其肌瘤的形态、大小、部位及数目、供血类型,然后进行栓塞治疗。 结果　(1)一侧子宫动脉供血为主型,即一侧子宫动脉的供血量超过子宫肌瘤主体的 1/2,表现该侧子宫动脉明显增粗,供血范围达到或超过肌瘤染色的 1/2,38 例,占51%。(2)双侧子宫动脉供血为主型,即双侧子宫动脉的供血量均超过子宫肌瘤主体的1/2,28例,占37%。(3)单纯一侧子宫动脉供血型,即肌瘤的血供全部来源于一侧子宫动脉,而另一侧子宫动脉不参与供血,9 例,占 12%。结论　无论是一侧子宫动脉供血为主型,双侧供血为主型,还是单纯一侧供血型子宫肌瘤都应行双侧子宫动脉栓塞才能彻底切断子宫肌瘤的血供。对于单纯一侧子宫动脉供血者,栓塞时供血侧应用永久性栓塞剂,另一侧应用短效栓塞剂,可避免侧支循环的形成和子宫肌层的坏死。Objective To investigate the angiographic features of angiography of uterine fibroid and its significance for uterine artery embolization. Materials and Methods There are 75 patients in this group, 9 fibroids were located under mucous membran, 50 in the myometrium, 16 under serous membrane, 21 single fibroid, 54 multiple fibroids. After local anesthesia, Seldinger technique was used, 5F Cobra cathter was placed in the bilateral uterine arteries, then the UAE was performed. The supply arteries, blood vessel, size, number, type of blood suppling were oberserved.Results (1)More than a half of fibroid's blood supply came from the unilateral uterine artery, 38(51%) patients were belong to this type. (2)The blood supply came from bilateral uterine arteries, 28(37%) patients were belong to this type. (3)The whole uterine blood came from only one side of uterine artery, 9(13%) patients were belong to this type.Conclusion Two sides of artery must be embolized regardless of what kind of type is. In the third type, permanent materials should be used in the blood supply artery, transient materials should be used in the other side to avoid lateral branch circulation and myometrium necrosis.

关 键 词：子宫肌瘤 血管造影 栓塞治疗 侧支循环 短效栓塞剂 

分 类 号：R737.33[医药卫生—肿瘤] R814.43[医药卫生—临床医学]