Ultrasonographic evaluation of the change in uterine fibroids induced by treatment with a GnRH analog.
OBJECTIVE
To investigate the change in volume of uterine fibroids after GnRH analog (GnRHa) treatment.


METHODS
Twenty-five patients who had a uterine leiomyoma were included in this study. Four of them were lost to follow-up during the study, and a myomectomy was performed on the remaining subjects. All of these patients received two doses, 4 weeks apart, each of 3.75 mg leuprorelin acetate subcutaneously (Leuplin depot, a GnRHa) before the operation. The vascularization index (VI), flow index (FI), vascularization-flow index (VFI), pulsative index (PI), resistance index (RI), vascular patterns (histogram), blood flows, and sizes (volume and largest diameter) of each fibroid were measured with power Doppler by the same technician every month before the operation. In addition, the total blood loss and time required for each operation were also recorded.


RESULTS
Results of this study showed that the volume of the uterus and the fibroids, but not the vascularity, including VI, FI, VFI, PI and RI, decreased significantly after two doses of GnRHa treatment. In addition, blood loss during the operation decreased significantly compared to an untreated group.


CONCLUSIONS
We found that the volumes of the uterus and fibroids decreased significantly after treatment with two consecutive doses (given a month apart) of GnRHa. The 3D color Doppler including a histogram and blood flow parameters is another useful tool for fibroid evaluation.
Chia
Chun-Chieh
CC
Department of Obstetrics and Gynecology, Chi Mei Hospital, Liouying, Tainan, Taiwan. chia007@iris.seed.net.tw
Huang
Soon-Cen
SC
Chen
Shen-Shien
SS
Kang
Jye-Yi
JY
Lin
Jing-Chuan
JC
Lin
Yuen-Shan
YS
Huang
Kuo-Feng
KF
Lee
Hung-Jung
HJ
Zheng
Ching-Cheng
CC
D000328:Adult; D001808:Blood Vessels / Q000000981:diagnostic imaging; D004334:Drug Administration Schedule; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007889:Leiomyoma / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008875:Middle Aged; D011446:Prospective Studies; D011674:Pulse; D012039:Regional Blood Flow; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014594:Uterine Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D014655:Vascular Resistance
D007987:Gonadotropin-Releasing Hormone