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.

Resumo

Objetivo Descrever as velocidades do fluxo sanguíneo e as alterações dos índices de impedância nas artérias uterinas leiomiomatoso utilizando a ultrassonografia Doppler.

Métodos Estudo prospectivo, caso-controle, realizado em 140 mulheres pré-menopáusicas com diagnóstico ultrassonográfico de leiomioma uterino e em 140 controles na pré-menopausa sem leiomiomas. A ultrassonografia pélvica foi realizada para diagnosticar e caracterizar os leiomiomas. A hemodinâmica dos ramos ascendentes de ambas as artérias uterinas principais foi avaliada por meio de interrogatório Doppler. A análise estatística foi feita principalmente por meio de testes não paramétricos.

Resultados A média do volume uterino dos das pacientes foi de 556 cm³, enquanto a dos controles foi de 90,5 cm³ (p < 0,001). A média de velocidade de pico sistólico (VPS), a velocidade diastólica final (VDF), a velocidade máxima do tempo médio (VMTM), a velocidade média do tempo médio (VMdTM), o tempo de aceleração (TA), o índice de aceleração (IA), a relação diástole/sístole (RDS), a proporção diastólica média (PDM) e o índice de pulsatilidade (IP) inversa foram significativamente maiores em pacientes (94,2 cm/s, 29,7 cm/s, 49,1 cm/s, 25,5 cm/s, 118 ms, 0,8, 0,3, 0,6 e 0,8, respectivamente) do que nos controles (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 e 0,4, respectivamente); p < 0,001 para todos os valores. Por outro lado, o IP médio, o índice de resistividade (IR), a relação sístole/diástole (RSD) e o índice de impedância (II) nas pacientes (1,52, 0,70, 3,81 e 3,81, respectivamente) foram significativamente mais baixos do que os dos controles (2,38, 0,86, 7,23 e 7,24, respectivamente); p < 0,001 para todos os valores.

Conclusão Existe um aumento significativo da perfusão dos úteros leiomiomatosos, que provavelmente se deve ao alargamento uterino.

Keywords

leiomyoma - uterine artery embolization - Doppler ultrasonography

Palavras-chave

leiomioma - embolização da artéria uterina - ultrassonografia com Doppler

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