ABSTRACT
BACKGROUND: Uterine fibroids present differently, from well vascularised up to calcified, with some causing heavy menstrual bleeding (HMB). OBJECTIVES: To investigate the association between fibroid vascularisation and HMB, other fibroid related symptoms and quality of life (QOL). MATERIALS AND METHODS: A single centre pilot study was carried out in the Netherlands. Women with a maximum of two fibroids who chose expectant management were included. 3D sonography including power doppler was performed at baseline and at 3, 6 and 12 months follow up. Women were asked to complete the Pictorial Blood Assessment Chart (PBAC) and Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaires at every visit. MAIN OUTCOME MEASURE: Main outcome measure: The association between fibroid vascularisation and HMB. RESULTS: 53 women were included in the study. Baseline fibroid vascularisation, measured as vascular index (VI) is associated with PBAC score; a 1% higher VI at baseline leads to an 11 point increase in PBAC score over time (RC 10.99, p=0.05, 95% CI -0.15 - 22.12). After correction for the baseline variables ethnicity and fibroid type the association becomes stronger (P<0.05). Fibroid volume at baseline and HMB are also associated: a 1 cm3 larger fibroid leads to 0.6 points increase in PBAC score over time (RC 0.56, p=0.03, 95% CI 0.05 - 1.07). CONCLUSIONS: Conclusions: This study highlights that both fibroid vascularisation and fibroid volume may be associated with an increase in menstrual blood loss, other fibroid related symptoms and QOL over time. WHAT IS NEW?: What is new? We used 3D power doppler to predict symptomatic fibroids.
ABSTRACT
OBJECTIVE: To analyse fibroid vascularisation measured with three-dimensional (3D) power Doppler in relation to absolute fibroid volume change during 12 months of follow up and in relation to fibroid growth rate per year. DESIGN: A prospective cohort study was performed between March 2012 and March 2014. SETTING: Outpatient clinic of the VU medical centre, Amsterdam. POPULATION OR SAMPLE: All premenopausal women diagnosed with a maximum of two fibroids with expectant management were consecutively included. METHODS: Three-dimensional ultrasound including power Doppler was performed at baseline, 3, 6 and 12 months. Volume and vascular parameters were calculated using VOCAL software. MAIN OUTCOME MEASURES: The relationship between vascular index (VI) at baseline and fibroid volume over time was analysed using linear mixed model analyses for repeated measurements. Second, the relationship between VI at baseline and fibroid growth rate per year was calculated using linear regression analyses. Analyses were adjusted for possible confounders. RESULTS: In all, 66 women (mean age 42 years) completed 12 months of follow up without treatment. Baseline fibroid vascularisation (VI) measured with 3D power Doppler is correlated with fibroid volume at 12 months (P = 0.02 ). An increase of 1% in VI at baseline was associated with a 7.00-cm3 larger fibroid volume at 12 months. Furthermore, vascularisation was also associated with fibroid growth rate per year (P = 0.04). CONCLUSION: In women with uterine fibroids without therapy, baseline vascularisation (VI) measured with 3D power Doppler is correlated with absolute fibroid volume change at 12 months and with fibroid growth rate per year. TWEETABLE ABSTRACT: Fibroid vascularisation correlates with absolute fibroid volume change and fibroid growth rate per year.
Subject(s)
Imaging, Three-Dimensional/methods , Leiomyoma/diagnostic imaging , Neovascularization, Pathologic/diagnostic imaging , Ultrasonography, Doppler/methods , Uterine Neoplasms/diagnostic imaging , Adult , Female , Humans , Predictive Value of Tests , Prospective Studies , Uterus/blood supply , Uterus/diagnostic imagingSubject(s)
Thyroglossal Cyst/diagnostic imaging , Ultrasonography, Prenatal , Adult , Female , Humans , Neck/diagnostic imaging , PregnancyABSTRACT
Touch screen computer-assisted health-related quality of life data collection in head and neck cancer patients is feasible. Touch screen computer-assisted health-related quality of life data collection can be used for scientific documentation as well as in clinical setting. Patients are willing to complete the questionnaire on a touch-screen and find the equipment easy to use. Compliance needs improvement by instructing clinicians and nurses and a better alert system.
