Uterine artery embolization for adenomyosis:evaluation of efficacy and analysis of predictive factors
10.3969/j.issn.1008-794X.2025.07.015
- VernacularTitle:子宫动脉栓塞治疗子宫腺肌症疗效评估及预测因素分析
- Author:
Hao ZHANG
1
;
Jinlian MA
;
Xingwei SUN
;
Mingyao WANG
;
Yong JIN
Author Information
1. 215004 江苏苏州 苏州大学附属第二医院
- Keywords:
uterine artery embolization;
adenomyosis;
efficacy;
predictive factor
- From:
Journal of Interventional Radiology
2025;34(7):766-771
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of uterine artery embolization(UAE)for the treatment of adenomyosis(AM)and to discuss the factors predicting efficacy.Methods The clinical data of 44 patients with AM,who received UAE at The Second Affiliated Hospital of Soochow University from January 2020 to August 2022,were retrospectively analyzed.Based on the MRI findings,serum CA125 levels and follow-up dysmenorrhea scores,the efficacy of UAE and the factors predicting efficacy were analyzed.Results A single UAE treatment was performed in all 44 patients with AM.Follow-up check with MRI at 12 months after treatment showed that the mean uterine volume decreased from preoperative(299.60±182.42)cm3 to postoperative(173.14±104.00)cm3,with a volume reduction of 36.64％(P＜0.05).The dysmenorrhea score decreased from preoperative(7.70±2.60)points to postoperative(2.20+2.37)points,with a relief rate of 88.64％(P＜0.05),and no severe adverse reactions occurred.Enhanced MRI demonstrated that in 30 patients(68.18％)the AM lesions presented as complete necrosis foci.In the patients whose preoperative lesions were completely necrotic,the mean preoperative serum CA125 level was(101.97±60.30)U/mL,the mean ADC value was(1.012+0.271)mm2/s,which were obviously lower than those in the patients whose preoperative lesions were incompletely necrotic(P＜0.05).The mean T2 signal ratio(T2SR)value in the patients whose preoperative lesions were completely necrotic was(0.582±0.198),which was significantly higher than that in the patients whose preoperative lesions were incompletely necrotic(P＜0.05).The analysis of receiver operating characteristic(ROC)curve showed that the preoperative area under the curve(AUC),sensitivity,and specificity for preoperative CA125 were 0.844,60％and 80％respectively;the AUC,sensitivity,and specificity for preoperative ADC were 0.760,80％and 65％respectively;and the AUC,sensitivity,and specificity for preoperative T2SR were 0.760,80％and 70％respectively.ADC＜1.116 × 10-3 mm2/s,T2SR＞0.479,and CA125＜109.10 U/mL could be used as the reliable predictive factors for the efficacy of UAE treatment for AM.Conclusion UAE can effectively alleviate dysmenorrhea symptoms in patients with AM,and it is clinically safe and effective.ADC,T2SR,and CA125 can be used as the reliable predictive factors for the efficacy of UAE treatment for AM,which are helpful in predicting the lesion response and selecting the reasonable therapeutic options for patients.
