rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2014-0-6-29-32rentrad-55Research ArticleСтатьиРЕЗУЛЬТАТЫ ЭМБОЛИЗАЦИИ МАТОЧНЫХ АРТЕРИЙ В ЛЕЧЕНИИ СИМПТОМНОЙ МИОМЫ МАТКИRESULTS OF UTERINE ARTERY EMBOLIZATION IN THE TREATMENT OF SYMPTOMATIC UTERINE MYOMAАлиакпаровМ. Т.AliakparovM. T.

д. м. н., профессор, академик Национальной академии наук Республики Казахстан, заведующий кафедрой визуальной диагностики

ул. Гоголя, 40, Караганда, 100000

MD, PhD, DSc, Professor, Academician of National Academy of Sciences of the Republic of Kazakhstan, Head of Department of Imaging

ul. Gogolya, 40, Karaganda, 100000

АбишевБ. Х.AbishevB. Kh.

д. м. н., профессор, заведующий отделением лучевой диагностики

пр-т Туран, 32, Астана, 010000

MD, PhD, DSc, Professor, Head of Radiology Department

prospekt Turan, 32, Astana, 010000

ТажибаевД. М.TazhibaevD. M.

врач лучевой диагностики

пр-т Туран, 32, Астана, 010000

ул. Гоголя, 40, Караганда, 100000

Radiologist

prospekt Turan, 32, Astana, 010000

ul. Gogolya, 40, Karaganda, 100000

ПительЕ. С.Pitel’E. S.

к. м. н., ассистент кафедры визуальной диагностики 

ул. Гоголя, 40, Караганда, 100000

MD, PhD, Assistant of Department of Imaging 

ul. Gogolya, 40, Karaganda, 100000

lpitel@rambler.ruКарагандинский государственный медицинский университетРоссияKaraganda State Medical UniversityRussian FederationАО «Национальный научный центр материнства и детства»РоссияNational Research Center of Maternity and ChildhoodRussian FederationАО «Национальный научный центр материнства и детства», Карагандинский государственный медицинский университетРоссияNational Research Center of Maternity and Childhood, Karaganda State Medical UniversityRussian Federation201401032016062932Copyright © Алиакпаров М.Т., Абишев Б.Х., Тажибаев Д.М., Питель Е.С., 20162016Алиакпаров М.Т., Абишев Б.Х., Тажибаев Д.М., Питель Е.С.Aliakparov M.T., Abishev B.K., Tazhibaev D.M., Pitel’ E.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/55

Цель исследования – оценить состояние матки и миоматозных узлов после эмболизации маточных артерий (ЭМА) в различные сроки методами ультразвукового исследования (УЗИ) и магнитно-резонансной томографии (МРТ).

Материал и методы

Материал и методы. ЭМА была выполнена у 632 пациенток с различными формами миомы матки. Для достижения поставленной цели было проанализировано 120 наблюдений с различными формами миомы матки.

Результаты

Результаты. Уменьшение миоматозных узлов по данным УЗИ и МРТ в 1-й мес составило соответственно 18,4 и 17,3%, через 3 мес – 40,7 и 42,9%, через 6 мес – 60,4 и 61,8%, через 12 мес – 72,5 и 74,7% (p<0,05). Выделение фрагментов некротизированного узла, экспульсия миоматозных узлов и удаление частично рождающегося субмукозного узла наблюдались в 18 (15%) случаях. В 12 (10%) наблюдениях после эмболизации маточных артерий была выполнена лапароскопическая миомэктомия субсерозных миоматозных узлов. Интраоперационная кровопотеря при этом составила 50–80 мл.

Заключение

Заключение. ЭМА является органосохраняющим, высокоэффективным методом лечения миомы матки, выполняемым в зависимости от разных форм изолированно или в комбинации с оперативным вмешательством.

Objective

Objective: to evaluate the uterus and myomatous nodules by ultrasonography and magnetic resonance imaging in different periods after uterine artery embolization (UAE).

Material and methods

Material and methods. UAE was performed in 632 patients with different forms of uterine myoma. With this aim in mind, 120 cases with different forms of uterine myoma were analyzed.

Results

Results. Following 1, 3, 6, and 12 months, the reduction in myomatous nodules was estimated to be 18.4 and 17.3, 40.7 and 42.9, 60.4 and 61.8 and 72.5 and 74.7%, respectively (p<0.05).  Necrotic exposure of a nodule, expulsion of myomatous  nodules, and removal of a partially nascent submucous nodule were observed in 18 (15%) patients. Laparoscopic myomectomy of subserous myomatous nodules was carried out in 12 (10%) cases after UAE. In doing this, interoperative blood loss was 50–80 ml.

Conclusion

Conclusion. UAE is an organ-sparing, highly effective uterine myoma treatment performed alone or in combination with surgery in relation to its different forms.

эмболизациярентгеноэндоваскулярная окклюзиямагнитно-резонансная томографиямиома маткиembolizationX-ray endovascular occlusionmagnetic resonance imaginguterine myomaReferencesOlive D. Review of the evidence for treatment of leiomyomata. Environmental Health Perspectives. 2000; 108 (Suppl. 5): 841–3.Olive D. Review of the evidence for treatment of leiomyomata. Environmental Health Perspectives. 2000; 108 (Suppl. 5): 841–3.Duhan N. Current and emerging treatments for uterine myoma – an update. Int. J. Womens Health. 2011; 3: 231–41.Duhan N. Current and emerging treatments for uterine myoma – an update. Int. J. Womens Health. 2011; 3: 231–41.Isonishi S., Coleman R., Hirama M. et al. Analysis of prognostic factors for patients with leiomyoma treated with uterine arterial embolization. Am. J. Obstet. Gynecol. 2008; 19: 270–8.Isonishi S., Coleman R., Hirama M. et al. Analysis of prognostic factors for patients with leiomyoma treated with uterine arterial embolization. Am. J. Obstet. Gynecol. 2008; 19: 270–8.Goodwin S., Vedantham S., McLucas B. et al. Preliminary experience with uterine artery embolization for uterine fibroids. J. Vasc. Intervent. Radiol. 1997; 8: 517–26.Goodwin S., Vedantham S., McLucas B. et al. Preliminary experience with uterine artery embolization for uterine fibroids. J. Vasc. Intervent. Radiol. 1997; 8: 517–26.Worthington-Kirsch R.L. Flow redistribution during uterine aftery embolization for the management of symptomatic fibroids. J. Vasc. Intervent. Radiol. 1999; 10 (2): 237–8.Worthington-Kirsch R.L. Flow redistribution during uterine aftery embolization for the management of symptomatic fibroids. J. Vasc. Intervent. Radiol. 1999; 10 (2): 237–8.Spies J.B., Ascher S.A., Goodwin S. Uterine artery embolization for leiomyomata. Obstet. Gynecol. 2001; 98: 29–34.Spies J.B., Ascher S.A., Goodwin S. Uterine artery embolization for leiomyomata. Obstet. Gynecol. 2001; 98: 29–34.Brunereau L., Herbreteau D., Gallas et al. Uterine artery embolization in the primary treatment of uterine leiomyomas: Technical features and prospertive follow-up with clinical and sonographic examination in 58 patients. Am. J. Roentgenol. 2000; 175: 1267–72.Brunereau L., Herbreteau D., Gallas et al. Uterine artery embolization in the primary treatment of uterine leiomyomas: Technical features and prospertive follow-up with clinical and sonographic examination in 58 patients. Am. J. Roentgenol. 2000; 175: 1267–72.Toor S.S., Jaberi A., Macdonald D.B., McInnes M.D., Schweitzer M.E., Rasuli P. Complication rates and effectiveness of uterine artery embolization in the treatment of symptomatic leiomyomas: a systematic review and meta-analysis. Am. J. Roentgenol. 2012; 199 (5): 1153–63.Toor S.S., Jaberi A., Macdonald D.B., McInnes M.D., Schweitzer M.E., Rasuli P. Complication rates and effectiveness of uterine artery embolization in the treatment of symptomatic leiomyomas: a systematic review and meta-analysis. Am. J. Roentgenol. 2012; 199 (5): 1153–63.Vedantham S., Goodwin S., McLucas B., Mohr G. Uterine artery embolization. Am. J. Obstet. Gynecol. 1997; 176: 938–48.Vedantham S., Goodwin S., McLucas B., Mohr G. Uterine artery embolization. Am. J. Obstet. Gynecol. 1997; 176: 938–48.Bobrov B., Kapranov S., Breusenko V., Dobrokhotova Yu., Krasnova I., Aksenova V., Aryutin D. Uterine artery embolization: a modern view of the problem. Diagn. Interv. Radiol. 2007; 1 (2): 56–70.Bobrov B., Kapranov S., Breusenko V., Dobrokhotova Yu., Krasnova I., Aksenova V., Aryutin D. Uterine artery embolization: a modern view of the problem. Diagn. Interv. Radiol. 2007; 1 (2): 56–70.Lumsden M. Embolization versus myomectomy versus hysterectomy: Which is best, when? Hum. Reprod. 2002; 17 (2): 253–9.Lumsden M. Embolization versus myomectomy versus hysterectomy: Which is best, when? Hum. Reprod. 2002; 17 (2): 253–9.Horhoianu I.A., Horhoianu V.V., Joita D., Carstoiu M., Dorobat B. Uterine artery embolization for leioyomas, ultrasonography and angiography aspects. J. Med. Life. 2012; 5 (4): 491–5.Horhoianu I.A., Horhoianu V.V., Joita D., Carstoiu M., Dorobat B. Uterine artery embolization for leioyomas, ultrasonography and angiography aspects. J. Med. Life. 2012; 5 (4): 491–5.Hutchins F., Worthington-Kirsch R., Berkowitz R. Selective uterine artery embolization as primary treatment for symptomatic leiomyomata uteri: A review of 305 consecutive cases. J. Am. Assoc. Gynecol. Laparosc. 1999; 6 (3): 279–89.Hutchins F., Worthington-Kirsch R., Berkowitz R. Selective uterine artery embolization as primary treatment for symptomatic leiomyomata uteri: A review of 305 consecutive cases. J. Am. Assoc. Gynecol. Laparosc. 1999; 6 (3): 279–89.Abbara S., Spies J., Scaialli A. et al. Transcervical expulsion of fibroids result of uterine artery embolization of leiomyomata. J. Vasc. Intervent. Radiol. 1999; 10 (4): 409–11.Abbara S., Spies J., Scaialli A. et al. Transcervical expulsion of fibroids result of uterine artery embolization of leiomyomata. J. Vasc. Intervent. Radiol. 1999; 10 (4): 409–11.

The authors declare that there are no conflicts of interest present.