剖宫产瘢痕妊娠动脉造影的影像学特点及临床意义
|
摘要
目的:通过动脉内数字减影血管造影(DSA)了解剖宫产瘢痕妊娠(CSP)的血供来源及分布特点。方法:回顾性分析74例在本院行子宫动脉栓塞(UAE)治疗的CSP患者的DSA资料,观察CSP的动脉血供来源及分布特点。结果:CSP的供血主要来自于子宫动脉和(或)卵巢动脉,其中由双侧子宫动脉供血者占97.3%,由卵巢动脉供血者占1.4%,由其他动脉供血者占1.4%。其供血分布可分I型,双侧子宫动脉供血均衡型,占83.8%;II型,一侧子宫动脉供血为主型,占13.5%;III型,卵巢动脉供血为主型,占1.4%;IV型,其他特殊类型,占1.4%。结论:CSP主要由双侧子宫动脉供血,但仍需注意由卵巢动脉供血等特殊情况。
Objective: To investigate the characteristics of the vascular supply of cesarean scar pregnancy(CSP) by digital subtraction angiography(DSA). Methods:The DSA data of 74 women with CSP treated by uterine arterial embolization(UAE) were analyzed retrospectively. The characteristics of source and distribution of arterial blood supplied CSP were observed. Results:The blood supply of CSP mainly came from uterine artery and/or ovarian artery. Blood of 97.3% CSP was supplied solely by the uterine artery, and 1.4% of CSP were mainly fed by ovarian artery, and the rest 1.4% were fed by the other arteries. The CSP blood supply was classified as bilateral balanced(83.8%), unilateral predominant(13.5%), mainly ovarian artery(1.4%), and other special type(1.4%). Conclusion:The blood of CSP is mainly supplied by bilateral uterine arteries, but it is still necessary to pay attention to special cases supplied by ovarian artery.
Objective: To investigate the characteristics of the vascular supply of cesarean scar pregnancy(CSP) by digital subtraction angiography(DSA). Methods:The DSA data of 74 women with CSP treated by uterine arterial embolization(UAE) were analyzed retrospectively. The characteristics of source and distribution of arterial blood supplied CSP were observed. Results:The blood supply of CSP mainly came from uterine artery and/or ovarian artery. Blood of 97.3% CSP was supplied solely by the uterine artery, and 1.4% of CSP were mainly fed by ovarian artery, and the rest 1.4% were fed by the other arteries. The CSP blood supply was classified as bilateral balanced(83.8%), unilateral predominant(13.5%), mainly ovarian artery(1.4%), and other special type(1.4%). Conclusion:The blood of CSP is mainly supplied by bilateral uterine arteries, but it is still necessary to pay attention to special cases supplied by ovarian artery.
引文
[1]欧阳振波.剖宫产瘢痕妊娠[M].北京:人民卫生出版社,2015(1):1-7.
[2]Gui T,Peng P,Liu X,et al.Clinical and ultrasound parameters in prediction of excessive hemorrhage during management of cesarean scar pregnancy[J].Ther Clin Risk Manag,2017,13:807-812.
[3]欧阳振波,尹倩,全松,等.复发性剖宫产瘢痕妊娠的诊断及治疗[J].现代妇产科进展,2016,25(10):754-757.
[4]Liu G,Wu J,Cao J,et al.Comparison of three treatment strategies for cesarean scar pregnancy[J].Arch Gynecol Obstet,2017,296(2):383-389.
[5]Fang Q,Sun L,Tang Y,et al.Quantitative risk assessment to guide the treatment of cesarean scar pregnancy[J].Int JGynaecol Obstet,2017,139(1):78-83.
[6]Zhenbo OY,Hongwei L,Song Q.The first-line approach for cesarean scar pregnancy:The most adopted being not the best[J].Taiwan J Obstet Gynecol,2016,55:761-762.
[7]欧阳振波,黄志霞,张秋实.剖宫产瘢痕妊娠的个性化综合治疗[J].妇产与遗传,2016,6(3):7-10.
[8]Hegde CV.Cesarean Scar Pregnancy:Some Management Options[J].J Obstet Gynaecol India,2017,67(3):153-156.
[9]Gonzalez N,Tulandi T.Cesarean Scar Pregnancy:A Systematic Review[J].J Minim Invasive Gynecol,2017,24(5):731-738.
[10]Chen CL,Xu YJ,Liu P,et al.Characteristics of vascular supply to uterine leiomyoma:an analysis of digital subtraction angiography imaging in 518cases[J].Eur Radiol,2013,23(3):774-779.
[11]陈春林,徐玉静,刘萍,等.子宫肌瘤数字化三维动脉血管网的构建及意义[J].介入放射学杂志,2012,21(1):35-39.
[12]陈春林,唐怡欣,刘萍.子宫肌瘤动脉血管网数字化三维模型构建与特点[J].中国实用妇科与产科杂志,2014,30(4):280-284.
[13]Zhang H,Huang J,Wu X,et al.Clinical classification and treatment of cesarean scar pregnancy[J].J Obstet Gynaecol Res,2017,43(4):653-661.
[14]Ma Y,Shao M,Shao X.Analysis of risk factors for intraoperative hemorrhage of cesarean scar pregnancy[J].Medicine(Baltimore),2017,96(25):e7327.
[15]Zhenbo OY,Qian Y,Song Q,et al.Uterine artery embolization in the treatment of recurrent cesarean scar pregnancy:report of two cases and literature review[J].Journal of Reproduction&Contraception,2015,26(4):249-255.
[16]欧阳振波,袁瑞莹,谢元梅,等.连续三次剖宫产瘢痕部位妊娠1例[J].实用妇产科杂志,2017,33(7):558.
[17]陈春林,段慧.数字化三维影像学与子宫肌瘤子宫动脉栓塞治疗[J].中国实用妇科与产科杂志,2016,32(12):139-145.
[18]刘晓宇,欧阳振波.卵巢动脉对子宫肌瘤动脉栓塞疗效及预后的影响[J].介入放射学杂志,2014,23(10):937-940.
[19]Zhenbo OY,Song Q.Regarding“anti-Müllerian hormone levels before and after uterine artery embolization”[J].Minim Invasive Ther Allied Technol,2018,5:1-2.
[20]欧阳小琴,尹倩,欧阳振波,等.子宫动脉栓塞对卵巢功能及生育力影响的研究进展[J].现代妇产科进展,2018,27(6).
[2]Gui T,Peng P,Liu X,et al.Clinical and ultrasound parameters in prediction of excessive hemorrhage during management of cesarean scar pregnancy[J].Ther Clin Risk Manag,2017,13:807-812.
[3]欧阳振波,尹倩,全松,等.复发性剖宫产瘢痕妊娠的诊断及治疗[J].现代妇产科进展,2016,25(10):754-757.
[4]Liu G,Wu J,Cao J,et al.Comparison of three treatment strategies for cesarean scar pregnancy[J].Arch Gynecol Obstet,2017,296(2):383-389.
[5]Fang Q,Sun L,Tang Y,et al.Quantitative risk assessment to guide the treatment of cesarean scar pregnancy[J].Int JGynaecol Obstet,2017,139(1):78-83.
[6]Zhenbo OY,Hongwei L,Song Q.The first-line approach for cesarean scar pregnancy:The most adopted being not the best[J].Taiwan J Obstet Gynecol,2016,55:761-762.
[7]欧阳振波,黄志霞,张秋实.剖宫产瘢痕妊娠的个性化综合治疗[J].妇产与遗传,2016,6(3):7-10.
[8]Hegde CV.Cesarean Scar Pregnancy:Some Management Options[J].J Obstet Gynaecol India,2017,67(3):153-156.
[9]Gonzalez N,Tulandi T.Cesarean Scar Pregnancy:A Systematic Review[J].J Minim Invasive Gynecol,2017,24(5):731-738.
[10]Chen CL,Xu YJ,Liu P,et al.Characteristics of vascular supply to uterine leiomyoma:an analysis of digital subtraction angiography imaging in 518cases[J].Eur Radiol,2013,23(3):774-779.
[11]陈春林,徐玉静,刘萍,等.子宫肌瘤数字化三维动脉血管网的构建及意义[J].介入放射学杂志,2012,21(1):35-39.
[12]陈春林,唐怡欣,刘萍.子宫肌瘤动脉血管网数字化三维模型构建与特点[J].中国实用妇科与产科杂志,2014,30(4):280-284.
[13]Zhang H,Huang J,Wu X,et al.Clinical classification and treatment of cesarean scar pregnancy[J].J Obstet Gynaecol Res,2017,43(4):653-661.
[14]Ma Y,Shao M,Shao X.Analysis of risk factors for intraoperative hemorrhage of cesarean scar pregnancy[J].Medicine(Baltimore),2017,96(25):e7327.
[15]Zhenbo OY,Qian Y,Song Q,et al.Uterine artery embolization in the treatment of recurrent cesarean scar pregnancy:report of two cases and literature review[J].Journal of Reproduction&Contraception,2015,26(4):249-255.
[16]欧阳振波,袁瑞莹,谢元梅,等.连续三次剖宫产瘢痕部位妊娠1例[J].实用妇产科杂志,2017,33(7):558.
[17]陈春林,段慧.数字化三维影像学与子宫肌瘤子宫动脉栓塞治疗[J].中国实用妇科与产科杂志,2016,32(12):139-145.
[18]刘晓宇,欧阳振波.卵巢动脉对子宫肌瘤动脉栓塞疗效及预后的影响[J].介入放射学杂志,2014,23(10):937-940.
[19]Zhenbo OY,Song Q.Regarding“anti-Müllerian hormone levels before and after uterine artery embolization”[J].Minim Invasive Ther Allied Technol,2018,5:1-2.
[20]欧阳小琴,尹倩,欧阳振波,等.子宫动脉栓塞对卵巢功能及生育力影响的研究进展[J].现代妇产科进展,2018,27(6).