Ultrasound (US) guidance has been a fundamental tool for interventionalists to perform percutaneous procedures. A limitation to US guidance is poor lesion visibility on conventional B-mode (brightness mode) US. Contrast-enhanced US (CEUS) is an adjunct technique that facilitates the visualisation and localisation of lesions.We review the use of CEUS and its application in liver interventions and describe the experience in our institution in using CEUS in these procedures.
Objective: To evaluate patients' experience of uterine artery embolisation (UAE) using a multidisciplinary team approach to treat symptomatic fibroids, as well as clinical outcome and radiological outcome, in our local institution. Methods: This was a single-centre retrospective follow-up study involving the departments of gynaecology, anaesthesiology, and radiology. All women who underwent UAE for symptomatic uterine fibroids from October 2014 to November 2017 were included. Patients received periprocedural monitored anaesthesia care (MAC) and postprocedural anaesthetic care including patient-controlled analgesia. Questionnaires were given to all patients 3 months after UAE to assess their experience in terms of pain control, length of hospital stay, and length of time until return to work. Magnetic resonance imaging was performed before and after UAE to assess radiological outcomes. Results: Periprocedural pain control with MAC and postprocedural pain control with patient-controlled analgesia had mean numeric rating scale pain scores (where 0 represented no pain and 10 represented worst pain imaginable) of 2.0 and 6.4, respectively. Of 26 patients, 14 (53.8%) had length of hospital stay of 2 nights, and 10 (38.5%) took 15 to 20 days to recover after the procedure and return to work. Significant reduction of uterine and fibroid volume was seen on MRIs after UAE (p < 0.001).
Conclusion:Preliminary results of our multidisciplinary team approach to UAE are promising in terms of patient experience, and radiological outcomes are consistent with the literature. Further studies are required for continuing clinical appraisal and improvement at our institution.
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