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.pdfVIP

入放射学杂志2005年2月第14誊 翅 』! ! !： ! ： 51 · 肿瘤介入· 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 梁志会， 崔进国， 潘新元， 周桂芬， 任美杰， 田惠琴， 应建伟 【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50例，浆膜下肌瘤l6例；单发肌瘤2l 例，多发肌瘤54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。 【关键词】子宫肌瘤；血管造影；栓塞 The significance of characteristic angiographic uterine artery anatomy for uterine fibroid artery embolization LIAN Zi-hui，CHUI Jin-guo， ⅣXing-yan，ZHOU~i-fen，REN Mei-jie，TIAN Hui-qin，YING Jian-wei． Radiolo#c Department Bethume International Pete Hospital，Shtjiazhuang Heibei 050082，China 【Abstract】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．1 6 under serous membrane．After puncture the fight femoral artery followed by angiography of bilateral uterine arteries，the orion 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 glut~al 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：①from both uterine arteries equally；②mainly from one uterine artery；③simply from one uterine artery．3．the ovarian artery． may be embol