Abstract

Introduction

Uterine fibroids are the most common benign neoplasms in women. The administration of intravenous oxytocin is known to increase the efficacy of a non-invasive thermal ablation method (MR-HIFU) for treating fibroids. However, it is not known whether this phenomenon is caused by the effect of the oxytocin on the myometrium or the fibroid itself. The objective of this study was to evaluate the influence of oxytocin on the blood flow of fibroids, myometrium and skeletal muscle using a quantitative perfusion MRI technique.

Materials and methods

17 premenopausal women with fibroids considered to be treated with MR-HIFU and 11 women with no fibroids were enrolled in the study. An extended MRI protocol of the pelvis was acquired for each subject. Later another MRI scan was performed with continuous intravenous infusion of oxytocin. The effect of oxytocin was analyzed from quantitative perfusion imaging. The study was registered in clinicaltrials.gov NCT03937401.

Results

Oxytocin decreased the blood flow of each fibroid; the median blood flow of fibroid was 39.9 ml/100 g tissue/min without and 3.5 mL/100 g/min with oxytocin (p ≤ 0.0001). Oxytocin did not affect the blood flow of the myometrium in either group. Oxytocin increased the blood flow of the skeletal muscle in both groups (p = 0.04).

Conclusion

Oxytocin is effective in decreasing the blood flow in fibroids while having minor or no effect on the blood flow of normal myometrium. Routine use of oxytocin in HIFU therapy may make the therapy suitable to a larger group of women in a safe manner.

中文翻译：

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催产素选择性地减少子宫肌瘤的血流而不影响子宫肌层的血流：动态对比增强的MRI评估

摘要

介绍

子宫肌瘤是女性中最常见的良性肿瘤。已知静脉内注射催产素可提高非侵入性热消融方法（MR-HIFU）治疗肌瘤的功效。但是，尚不知道这种现象是由催产素对子宫肌层或肌瘤本身的作用引起的。这项研究的目的是使用定量灌注MRI技术评估催产素对肌瘤，子宫肌层和骨骼肌血流的影响。

材料和方法

这项研究纳入了17例经肌瘤治疗的绝经前女性，其中11例无肌瘤的女性。每个对象都获得了骨盆的扩展MRI协议。之后，通过连续静脉注射催产素进行另一次MRI扫描。从定量灌注成像分析催产素的作用。该研究已在Clinicaltrials.gov NCT03937401中注册。

结果

催产素减少了每个肌瘤的血流量；肌瘤的中值的血流是没有39.9毫升/ 100 g组织/分钟和3.5毫升/ 100克/分钟，催产素（p  ≤0.0001）。两组中的催产素均不影响子宫肌层的血流。催产素增加了两组骨骼肌的血流量（p  = 0.04）。

结论

催产素可有效减少肌瘤中的血流，而对正常子宫肌层的血流几乎没有影响。HIFU治疗中常规使用催产素可以使该疗法以安全的方式适用于较大的女性人群。