RESUMO
BACKGROUND: Uterine artery embolisation (UAE) has evolved as a minimally invasive and effective alternative, treatment modality for women with symptomatic fibroids. We discuss our initial experience of UAE in the management of symptomatic fibroids. METHODS: Twenty five symptomatic patients of uterine fibroids were treated with UAE by selectively cannulating and injecting poly vinyl alcohol particles into the uterine arteries. Post treatment follow up was done at 2 and 6 months respectively. RESULTS: Pre-treatment, the sizes of fibroids were between 3.9 and 10.9 cm (mean 7.4) on ultrasonography. Of the total 25 patients, 49 uterine arteries were embolised with a technical success rate of 98%. Menorrhagia persisted in 7 patients, dysmenorrhea in 4 patients and pressure symptoms in 2 patients respectively in follow up study of six months which corresponds to a reduction in symptoms by 68% for menorrhagia, 71% for dysmenorhoea and 75% for those with pressure symptoms respectively. At 2 months follow-up post embolisation, the mean diameter of the fibroid was 4.03 cm (range 2-5.2 cm) and at 6 months 3.2 cm (range 1.3-4.1 cm), corresponding to size reduction of 45.5% and 57%, respectively. Follow up with ultrasonography at 2 and 6 months period showed successful fibroid reduction in 24 patients with corresponding reduction in the symptomatology. One patient remained symptomatic with increase in fibroid size and had to undergo hysterectomy. CONCLUSION: Uterine artery embolisation can be considered as an alternative to hysterectomy in appropriately selected symptomatic patients of uterine fibroids.
RESUMO
Virtual scopy is a computerized, non-invasive technique used in simulating views provided by a fiber optic endoscope. Multidetector CT (MDCT) enhances the technique of Virtual scopy, by its z-axis resolution, faster data acquisition and improved 3D-image quality. The common application included Virtual Colonoscopy, Bronchoscopy, Gastroscopy, Angioscopy, Labyrinthoscopy, Thoracoscopy and Stentoscopy. Of the 45 Virtual scopies referred to Radiology Department at INHS Asvini, the single largest application was Virtual Angioscopy followed by Stentoscopy and the smallest was evaluation of larynx, labyrinth, colon and mediastinum accounting for 3 each. Endoscopy data and histopathological diagnosis was available in 17 patients, who underwent Virtual studies of larynx, airway, stomach, mediastinum and colon.
