ECHOGRAPHY MONITORING WHEN TREATING MYOMA UTERI BY ARTERIES UTERI EMBOLIZATION METHOD

Purpose: Determining the echography and dopplerography particularities of the myomas process after embolization of the arteries uteri.

Methods and Materials: Checkup of 33 patients with myoma who underwent transcutaneas embolization of the arteries uteri. The average age of the patients was 38,1 + 3,1. All women were in reproductive period. The ultrasound investigations were conducted not later than 2 months before operations as well as 6–7 and 10–12 months after the operation. In addition to the standard measurements, the number of tumors, there anatomic localization, average diameter, structure and echogenicity of each nodule, type and degree of vascularization were determined, the spectral dopplerography data was registered, such as resistance index (IR), maximal arterial and venous velocity (MAV, MVV). The minimal values of IR and the maximal values of MAV and MVV were used in analysis. The pelvic pains in 16 (48,5%) cases caused the necessity for treatment, uteri bleeding – in 10 (30,3%) cases and a combination of signs – in 11 (33,3%) cases.

Results: The dynamic monitoring showed that the myoma reduction within half a year equals 58,8% and within the year –71,1%. The echogenicity of nodules increases, its structure becomes heterogeneous, with the advent of high echogenicity inclusions and unechogenic cavities. The vascularization of myoma decreases substantially right down to avascularization. I cases when the vessels undergo vascularization they are determined predominantly by the periphery of the tumor. Statistically true increase of the peripheral resistance index is noted while the myoma vessels arterial and venous velocity indices do not show meaningful differences (see Table).

Table:

Myoma Dopplerography indices before and after the embolization of

Test time	IR	MAV	MVV
Before operation	0,60 + 0,06	14,7 + 3,8	6,0 + 2,3
After 6–7 months	0,78 + 0,14	14,2 + 2,7	3,2 + 1,2
After 10–12 mont	0,80 + 0,09	14,3 + 2,9	3,4 + 1,8

Conclusions: Due to embolization of the arteries uteri the vizualization of the myoma vessels reduces, while the vessel resistance in them increases. The arterial and the venous velocity do not manifest significant changes.

As the result of the myoma uterus organs upkeeping treatment the pregnancy followed with 2 patients, one of them – with the help of the assist reproductive technology.