The construction of digital 3D arterial vascular network of uterine leiomyomas and its clinical significance

Objective: To discuss the method of constructing digital 3D arterial vascular network of uterine leiomyomas based on the CTA data, by which to lay the fundamental work for the observation of the origin and distribution of hysteromyoma blood supply. Methods: A total of 64 cases of uterine leiomyomas were enrolled in this study. Dual-source CT angiography was performed in all the patients, and the CTA original images were obtained. By using Mimics 10.01 software the digital 3D arterial vascular network of uterine was reconstructed. The reconstructed models were analyzed. Results: (1) The constructing process of arterial vascular network was successfully accomplished in all 64 patients. The pelvic main arteries, the uterine arteries and tumor-feeding arteries as well as the blood distribution type were clearly demonstrated on the reconstructed images. (2) The origins of hysteromyoma blood supply included uterine artery (81.25%), uterine artery and unilateral ovarian artery (10.94%), uterine artery and bilateral ovarian artery (4.69%) and ovarian artery (3.12%). (3) Distribution pattern of blood supply of uterine leiomyomas could be divided into 4 types: (1) Type Ⅰ. The unilateral arterial blood supply dominant type (unilateral uterine artery with or without ipsilateral ovarian arterial, providing more than 1/2 blood supply of hysteromyoma), which accounted for 35.94% of all patients (23/26); (2) Type Ⅱ. The bilateral arterial blood supply balanced type (bilateral uterine artery with or without ipsilateral ovarian artery, providing about 1/2 blood supply of hysteromyoma), which accounted for 53.13% of all patients (34/64); (3) Type Ⅲ. The unilateral uterine artery was the main blood supply of uterine leiomyomas, which accounted for 7.81% of all patients (5/64); (4) Type Ⅳ. The ovarian artery was the main blood supply of uterine leiomyomas, which accounted for 3.13% of all patients (3/64). Conclusion: Based on CTA data and with the help of reconstruction software, the digital 3D arterial vascular network of uterine leiomyomas can be successfully established, which can be used to determine the source of the blood supply, to observe the blood distribution of hysteromyoma and to provide useful reference for the making of therapeutic plan and for the teaching in clinical practice. (authors)