@article{oai:hama-med.repo.nii.ac.jp:00003964,
 author = {瀬川, 将史 and 田中, 里美 and 牧野, 祐也 and 加藤, 雅也 and 伊藤, 早紀 and 保田, 歩 and 石田, ゆり and 村瀬, 佳子 and 矢田, 昌太郎 and 金田, 容秀 and 田中, 利隆},
 issue = {1},
 journal = {静岡産科婦人科学会雑誌},
 month = {Mar},
 note = {子宮仮性動脈瘤（Uterine Artery Pseudoaneuysm：UAP）は帝王切開術や子宮内膜掻爬術後などに発生し、性器出血を主症状とし破裂後に診断されることが多い。UAPの治療には子宮動脈塞栓術（Uterine artery embolization：UAE）が有効であるが、自然消失する例もあり、明確な管理・治療方針はない。そこで、我々は当院におけるUAP17例を検討し管理方法・治療戦略について考察した。UAEが施行されたのは3例でいずれもUAP径は20mm以上であり、自然消失した14例のUAP径が平均11mmであったの対し、UAP径は大きい傾向を示した。UAEが施行された3例のうち1例は妊娠後期の分娩後に発生したUAPで大量出血をきたし、造影CT検査3D血管構築像でUAPに豊富な側副血行路を認めた。一方、UAE未施行例ではUAPに側副血行路は認めなかった。UAP径の大きさ、および3DCT血管構築像でUAPへの側副血行路の有無を評価することは、UAEなどの治療介入の必要性を評価することに有用な可能性がある。, Uterine Artery Pseudoaneuysm (UAP) occurs after cesarean section and endometrial curettage and is often diagnosed after rupture with genital bleeding as a chief complaint. Uterine artery embolization (UAE) is effective in treating UAP, but there is no clear management and treatment strategy for UAP because it can disappear spontaneously. Therefore, we examined 17cases of UAP in our hospital and considered the management and treatment strategy of UAP. The average UAP diameter of 14cases which disappeared spontaneously was 11mm, whereas the UAP diameter of 3cases which underwent UAE was more than 20mm. One of 3case which underwent UAE occurred the massive bleeding due to rupture after delivery in the third trimester, and three-dimensional multislice computed tomographic angiography (3DCTA) showed the rich collateral circulation around UAP. No collateral circulation was found in the cases which did not undergo UAE. Evaluating the size of the UAP diameter and the presence or absence of collateral circulation to the UAP with 3DCTA may help assess the need for therapeutic interventions such as UAE.},
 pages = {10--19},
 title = {子宮仮性動脈瘤における治療戦略},
 volume = {11},
 year = {2022}
}