دانلود رایگان مقاله امبولیسم شریان رحمی بر میزان لیومیوم مدیریت پس از عمل جراحی مغز استخوان

Abstract

Purpose: The aim of this study was to determine whether a self-referred population screened by an interventional radiology (IR) clinic and a non-IR, physician-referred population differed with regard to suitability for uterine artery embolization (UAE) for symptomatic leiomyomas on the basis of preprocedure MRI. Methods: This was an institutional review boardeapproved, HIPAA-compliant retrospective study of 301 women evaluated in an IR clinic for possible UAE from January 2009 to September 2012. Subjects were retrospectively divided into two groups: self-referred via direct marketing (group A, n ¼ 203; mean age, 41.8 years; range, 22-58 years) and physician referred (group B, n ¼ 98; mean age, 42.9 years; range, 30-65 years). Results: There was no significant difference between groups in presenting symptoms (multiple symptoms, bleeding, bulk-related symptoms, pain). After initial screening, 73.4% of group A (149 of 203) and 79.6% of group B (78 of 98) underwent MRI (P ¼ .242). On the basis of MRI findings, 91.3% of group A (136 of 149) and 94.9% of group B (74 of 78) had uterine leiomyomas (P ¼ .328). Adenomyosis without leiomyoma was present in 4.0% of group A (6 of 149) and 3.8% of group B (3 of 78) (P ¼ .947). Incidental findings requiring further clinical or imaging evaluation were found in 20.8% of group A (31 of 149) and 24.4% of group B (19 of 78) (P ¼ .539). After MRI, 41.6% of group A (62 of 149) and 48.7% of group B (38 of 78) proceeded to UAE (P ¼ .306). Conclusions: After initial screening, similar proportions of self-referred and physician-referred patients were candidates for UAE. The rates of confirmed leiomyomas and incidental findings on MRI were similar between groups.

CONCLUSIONS

A direct marketing campaign has been shown to increase IR clinic volume, but after an initial screening process, the incidence of leiomyomas, alternative diagnoses such as adenomyosis, and incidental findings is not signifi- cantly different between patients who are self-referred and those who are physician referred. Similar percentages of patients from both groups proceed to UAE.