期刊
CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY
卷 36, 期 3, 页码 676-681出版社
SPRINGER
DOI: 10.1007/s00270-012-0485-y
关键词
Arterial intervention; Embolization; Embolotherapy; Fibroid; Urogenital
资金
- Chief Scientist Office, Scottish Government Health Directorates, St. Andrew's House, Regent Road, Edinburgh, Scotland, UK [EH1 3DG]
- MRC [G0800803] Funding Source: UKRI
- Medical Research Council [G0800803] Funding Source: researchfish
To report 5-year contrast-enhanced magnetic resonance imaging findings of the REST trial recruits who underwent either uterine artery embolization (UAE) or myomectomy. A total of 157 patients were randomized to UAE or surgery (hysterectomy or myomectomy). Ninety-nine patients who had UAE and eight patients who had myomectomy were analyzed. MRI scans at baseline, 6 months, and 5 years were independently interpreted by two radiologists. Dominant fibroid diameter, uterine volume, total fibroid infarction (complete 100 %, almost complete 90-99 %, partial < 90 %), and new fibroid formation were the main parameters assessed and related to the need for reintervention. In the UAE group, mean +/- A standard deviation uterine volume was 670 +/- A 503, 422 +/- A 353, and 292 +/- A 287 mL at baseline, 6 months, and 5 years, respectively. Mean dominant fibroid diameter was 7.6 +/- A 3.0, 5.8 +/- A 2.9, and 5 +/- A 2.9 cm at baseline, 6 months, and 5 years. Fibroid infarction at 6 months was complete in 35 % of women, almost complete in 29 %, and partial in 36 %. Need for reintervention was 19, 10, and 33 % in these groups, respectively (p = 0.123). No myomectomy cases had further intervention. At 5 years, the prevalence of new fibroid was 60 % in the myomectomy group and 7 % in the UAE group (p = 0.008). There is a further significant reduction in both uterine volume and dominant fibroid diameter between 6 months and 5 years after UAE. Complete fibroid infarction does not translate into total freedom from a subsequent reintervention. New fibroid formation is significantly higher after myomectomy.
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