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- Title
Serial follow up of uterine leiomyoma patient receiving GnRH-agonist with 3D power Doppler ultrasonography.
- Authors
Cheng, Ya-Min; Hsu, Ken-Fu; Huang, Soon-Cen; Chou, Cheng-Yang
- Abstract
Uterine leiomyoma is a common benign neoplasm noted during reproductive age. It will induce various clinical symptoms and signs such as hypermenorrhea, pressure symptoms, anemia and subfertility. For subfertihty patients with uterine leiomyoma, conservative treatment with myomectomy is mandatory to preserve the uterus. Preoperative Gonadotropin releasing hormone agonist (GnRH-a) injection was reported to have the benefits of decrease blood loss and tumor volume that reduce the morbidity of this surgical procedure. However, the preoperative effective prediction method for blood loss decreasing was lacking. Three-dimensional (3D) power Doppler ultrasonography uses the amplitude component of the signals received to present the number of moving blood cells. It has been found to be superior to frequency-based color Doppler sonography, especially in situations of low-velocity blood flow and it is more sensitive, less angle-dependent, and not susceptible to aliasing. This allows the visualization of small vessels and lower flows. Case summery A 32-years-old married woman, GOP0, came to our clinic with the chief complaint of hypermenorrhea and anemia (Hb 7.6, Hct 24.8). Sonography showed an 8-cm leiomyoma located at posterior uterine wall. She received Leuplin depot (3.75 mg) injection monthly for three months. 3D power Doppler ultrasound follow up also performed before each injection. The tumor size decreased gradually from 8 × 8 cm to 7.5 × 6.8 cm. Serial power Doppler ultrasound follow up showed obvious decrease in power Doppler signal. She received myomectomy later and pathology proved leiomyoma. The blood loss during operation was minimal (about 20 mL). Discussion The administration of gonadotropin-releasing hormone (GnRH) agonist was reported to have good treatment effect on the leiomyoma including shrinkage of tumor volume to 20-30% after three doses of injection. This treatment effect was achieved via hypoestrogenism, decrease tumor growth factors...
- Subjects
UTERINE fibroids; DOPPLER ultrasonography
- Publication
Journal of Obstetrics & Gynaecology Research, 2003, Vol 29, Issue 3, p212
- ISSN
1341-8076
- Publication type
Article