Magnetic resonance is a useful modality for evaluating skeletal muscle and allows for the assessment of disease burden. It can elucidate potential targets for biopsy. Newer magnetic resonance techniques can acquire functional information in addition to anatomic information and hold tremendous potential for detecting, characterizing, and monitoring treatment for inflammatory myopathies.
Purpose: To assess long-term clinical efficacy of uterine artery embolization compared to abdominal myomectomy.Materials and Methods-Consecutive women who received either uterine artery embolization or abdominal myomectomy for symptomatic uterine leiomyomata between 2000 and 2002 at a single institution were enrolled. We include patients whose procedures were performed 5 years prior to the study. Symptom evaluations using symptom severity scores, pregnancy rates and satisfaction of the procedures were obtained by IRB-approved questionnaires. Chart reviews were performed to supplement analyses.Results-The retrospective cohort included 185 patients, including 87 uterine artery embolization patients (47.0%) and 98 abdominal myomectomy patients (53.0%). Eighty nine patients (48.1%) completed the long-term follow-up, of whom 48 had uterine artery embolization and 41 had abdominal myomectomy. Follow up ranged from 50 to 83 months.A higher but not statistically significant number of patients received repeat interventions after abdominal myomectomy (14%) than uterine artery embolization (8%) (p=0.204). Statistically significantly higher symptom severity score improvement in patients with uterine artery embolization than abdominal myomectomy was seen (34 vs 31, p = 0.02). Uterine artery embolization patients were less likely to attempt to get pregnant (p = 0.02), however those who did had a 66.7% success rate compared with 58.8% for abdominal myomectomy patients. Similar numbers of patients with uterine artery embolization were satisfied (p= 0.57), reported effectiveness in relieving symptoms (p=0.43), and would recommend the procedure (p=0.37) compared with abdominal myomectomy patients.Conclusion-Uterine artery embolization results in long-term clinical success with outcomes comparable or superior to abdominal myomectomy.
Diagnostic imaging plays an essential role in the evaluation of disease processes that affect the upper airway. Imaging allows for the localization and characterization of various conditions that are often occult on physical examination. Plain radiography maintains a limited role in airway evaluation, whereas advanced imaging modalities, including computed tomography and magnetic resonance imaging, have emerged as indispensable tools in patient evaluation. Common disease entities affecting the upper airway in the adult population, including trauma, infectious/inflammatory diseases, and neoplastic diseases, as well as other common pathologic conditions are reviewed in this article.
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