Uterine Artery Doppler Velocimetry of Uterine Leiomyomas in Nigerian Women

Abstract Objective To describe the blood flow velocities and impedance indices changes in the uterine arteries of leiomyomatous uteri using Doppler sonography. Methods This was a prospective, case-control study conducted on 140 premenopausal women with sonographic diagnosis of uterine leiomyoma and 140 premenopausal controls without leiomyomas. Pelvic sonography was performed to diagnose and characterize the leiomyomas. The hemodynamics of the ascending branches of both main uterine arteries was assessed by Doppler interrogation. Statistical analysis was performed mainly using non-parametric tests. Results The median uterine volume of the subjects was 556 cm3, while that of the controls was 90.5 cm3 (p < 0.001). The mean peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged maximum velocity (TAMX), time-averaged mean velocity (Tmean), acceleration time (AT), acceleration index (AI), diastolic/systolic ratio (DSR), diastolic average ratio (DAR), and inverse pulsatility index (PI) were significantly higher in the subjects (94.2 cm/s, 29.7 cm/s, 49.1 cm/s, 25.5 cm/s, 118 ms, 0.8, 0.3, 0.6, and 0.8 respectively) compared with the controls (54.2 cm/s, 7.7 cm/s, 20.0 cm/s, 10.0 cm/s, 92.0 ms, 0.6, 0.1, 0.4, and 0.4 respectively); p < 0.001 for all values. Conversely, the mean PI, resistivity index (RI), systolic/diastolic ratio (SDR) and impedance index (ImI) of the subjects (1.52, 0.70, 3.81, and 3.81 respectively) were significantly lower than those of the controls (2.38, 0.86, 7.23, and 7.24 respectively); p < 0.001 for all values. Conclusion There is a significantly increased perfusion of leiomyomatous uteri that is most likely due to uterine enlargement.

摘要
目的：本研究旨在通过多普勒超声检查（Doppler sonography），描述子宫肌瘤（uterine leiomyoma）子宫的动脉血流速度及阻抗指数变化情况。
方法：本研究为前瞻性病例对照研究，共纳入140名经超声诊断为子宫肌瘤的绝经前女性作为病例组，另纳入140名无子宫肌瘤的绝经前女性作为对照组。采用盆腔超声检查对子宫肌瘤进行诊断及特征分型，通过多普勒检测评估双侧子宫动脉上行支的血流动力学状态。统计学分析主要采用非参数检验方法。
结果：病例组受试者的子宫体积中位数为556 cm³，对照组为90.5 cm³（p < 0.001）。病例组的平均收缩期峰值流速（peak systolic velocity, PSV）、舒张末期流速（end-diastolic velocity, EDV）、时间平均最大流速（time-averaged maximum velocity, TAMX）、时间平均平均流速（time-averaged mean velocity, Tmean）、加速时间（acceleration time, AT）、加速指数（acceleration index, AI）、舒张收缩比（diastolic/systolic ratio, DSR）、平均舒张比（diastolic average ratio, DAR）及搏动指数倒数（inverse pulsatility index, PI）均显著高于对照组，对应数值分别为94.2 cm/s、29.7 cm/s、49.1 cm/s、25.5 cm/s、118 ms、0.8、0.3、0.6及0.8；对照组对应数值依次为54.2 cm/s、7.7 cm/s、20.0 cm/s、10.0 cm/s、92.0 ms、0.6、0.1、0.4及0.4，所有指标差异均具有统计学意义（p < 0.001）。与之相反，病例组的平均搏动指数（pulsatility index, PI）、阻力指数（resistivity index, RI）、收缩舒张比（systolic/diastolic ratio, SDR）及阻抗指数（impedance index, ImI）均显著低于对照组，对应数值分别为1.52、0.70、3.81及3.81；对照组对应数值依次为2.38、0.86、7.23及7.24，所有指标差异均具有统计学意义（p < 0.001）。
结论：子宫肌瘤患者的子宫灌注量显著升高，该变化极大概率与子宫体积增大相关。