探讨彩色多普勒超声对医源性子宫动、静脉瘘(AVMs)的诊断及子宫动脉灌注栓塞术(UAE)对其治疗价值的评估、监测研究。

选择自2007年1月至2012年12月在深圳市妇幼保健院就诊的8例医源性子宫AVMs患者为研究对象。记录其子宫形态及病灶区二维声像图、彩色多普勒血流(CDFI)显像和频谱特点，测定收缩期峰值速率(PSV)和阻力指数(RI)，分析其经血管造影确诊的医源性子宫AVMs的临床、彩色多普勒超声声像特征及UAE治疗的近、远期疗效，并对结果进行分析(本研究遵循的程序符合深圳市妇幼保健院人体试验委员会所制定的伦理学标准，得到该委员会批准，并与受试者签署临床研究知情同意书)。

本组8例患者在血管造影及UAE治疗前，均经彩色多普勒超声提示为子宫AVMs，其主要声像特征为宫壁均见单发类圆形无回声区，彩色多普勒显示无回声区内有丰富混叠血流信号充填；CDFI频谱显示，低阻高速血流，静脉血流动脉化频谱。所有患者在UAE治疗后2 d内出血停止。对其随访7～42个月(平均为27个月)的结果显示，均未复发出血，复查彩色多普勒超声无异常声像。本组2例患者治疗后正常受孕。

彩色多普勒超声对医源性子宫AVMs的诊断及UAE对其治疗价值的评估监测有重要价值。UAE治疗医源性子宫AVMs的近、中期效果好，治疗后仍可能生育，其远期效果尚需进一步观察。

To evaluate ultrasonographic diagnosis and monitoring the efficacy of uterine arterial infusion and embolization(UAE) in patients with iatrogenic traumatic uterine arteriovenous malformations (AVMs).

Eight clinic patients with (AVMs) of Shenzhen Maternity & Child Healthcare Hospital were chose as study objective in the period between January 2007 and December 2012. The uterus morphology, the features in grey scale image, color flow Doppler image (CDFI) and Spectrum of focuses were recorded. The peak systolic velocity (PSV) and index of resistance (RI) were measured. The clinical and CDFI sonographic features were analysed and the short and long efficacy of embolotherapy was evaluated for patients with AVMs confirmed by angiography.The results were carried out statistical analysis.(the study was in accordance with human ethical standards by Institutional Review Board of Shenzhen Maternity & Child Healthcare Hospital and the clinical study informed consent should be signed with the patient).

All 8 cases with AVMs presented with similar circular anechoic spaces within the myometrium on the gray scale ultrasonography, CDFI showed a florid mosaic pattern with color aliasing in the anechoic spaces, and pulsed Doppler showed rapid and turbulent systolic blood flow with increased diastolic flow suggestive of arteriovenous fistula. Bleeding was controlled in all cases in two days after intra-arterial embolization. No recurrence bleeding and no abnormal features were found on CDFI ultrasonography during follow-up range 7 months to 42 months (median 27 months). Two patients became normally pregnant after embolization.

Color flow Doppler ultrasound is an important skill for diagnose and monitoring the efficacy of embolotherapy in patients with iatrogenic traumatic uterine AVMs. Uterine artery embolotherapy is a safe and effective short and median term treatment efficacy for traumatic AVMs. Future pregnancy is still possible after embolization. But the long term efficacy need next study in the future.