The role of dopplerometry in the assessment of local hemodynamics in patients with uterine fibroids

Abstract

The purpose of the study is to evaluate the features of velocymetric hemodynamics in perinodular tissues in uterine fibroids, depending on the size of the node and the presence of degenerative changes. Material and methods. The research was carried out in 2020–2023 at the clinical units of Odesa National Medical University (Odesa, Ukraine). A clinical, instrumental, and laboratory study was conducted in 275 women of reproductive age with verified uterine fibroids. Results. The average volume of the dominant leiomyoma node was (84.2 ± 0.1) cm3 (corresponding to the range of (21.5–328.0) cm3). The dominant fibroid node was vascular in 226 (82.2%) patients and nonvascular in 49 (17.8%) patients. 138 (50.2%) vascular dominant myoma nodules showed only peripheral (perifibroid) vascularity, whereas 62 (44.3%) showed both peripheral and central (intrafibroid) vascularity. The average linear velocity of blood flow in the uterine arteries was (39.6 ± 0.4) cm/s with the resistance index of 0.8±0.04 and the pulsatility index of 1.4 ± 0.05. Conclusions: 1. The average velocity of blood flow in the largest myomatous node does not exceed (15.6 ± 0.8) cm/s with the resistance index of 0.7 ± 0.03 and the pulsatility index of 1.2 ± 0.09, which can be explained by a tendency to hypovascularization. 2. The main type of angioarchitectonics of myomatous nodes are nodes with peripheral vascularization, that is, with vessels that surround the myomatous node on its periphery. The angioarchitectonics of fibroids depends on the size of the nodes, their localization, the presence of changes in the adjacent endometrium. 3. Dominant nodes with both perifibroid and intrafibroid vascularity have a significantly larger (p = 0.004) average volume (225.5 ± 12.2) cm3 than nodes with only perifibroid vascularity (average volume = 157.2 ± 9.5 cm3) or avascular nodes (up to 50 cm3). 4. The degree of vascularization significantly increased with the increase in the volume of the dominant myomatous node (r = 0.75; p < 0.05).

Мета дослідження – оцінити особливості велосиметричної гемодинаміки в перинодулярних тканинах за міоми матки залежно від розміру вузла та наявності дегенеративних змін. Показано, що середня швидкість кровотоку в найбільшому міоматозному вузлі не перевищує (15,6 ± 0,8) см/с за індексу резистентності 0,7 ± 0,03 та індексу пульсації 1,2 ± 0,09. Домінуючі вузли мають значно більший (p = 0,004) середній об’єм (225,5 ± 12,2) см3, ніж вузли лише з перифиброїдною васкулярністю (середній об’єм = (157,2 ± 9,5) см3) або безсудинними вузлами (до 50 см3). Ступінь васкуляризації вірогідно зростав зі збільшенням об’єму домінантного міоматозного вузла (r = 0,75 p < 0,05).