Alterações endometriais após embolização de leiomiomas uterinos avaliadas por ressonância magnética de alto campo (3 Tesla)

Abstract

Objective:To evaluate the endometrial alterations related to embolization of uterine arteries for the treatment of symptomatic uterine leiomyomatosis (pelvic pain and/or uterine bleeding) by means of high-field (3-Tesla) magnetic resonance.Methods:This is a longitudinal and prospective study that included 94 patients with a clinical and imaging diagnosis of symptomatic uterine leiomyomatosis, all of them treated by embolization of the uterine arteries. The patients were submitted to evaluations by high-field magnetic resonance of the pelvis before and 6 months after the procedure. Specific evaluations were made of the endometrium on the T2-weighted sequences, and on the T1-weighted sequences before and after the intravenous dynamic infusion of the paramagnetic contrast. In face of these measures, statistical analyses were performed using Student's t test for comparison of the results obtained before and after the procedure.Results:An average increase of 20.9% was noted in the endometrial signal on T2-weighted images obtained after the uterine artery embolization procedure when compared to the pre-procedure evaluation (p=0.0004). In the images obtained with the intravenous infusion of paramagnetic contrast, an average increase of 18.7% was noted in the post-embolization intensity of the endometrial signal, compared to the pre-embolization measure (p<0.035).Conclusion:After embolization of the uterine arteries, there was a significant increase of the endometrial signal on the T2-weighted images and on the post-contrast images, inferring possible edema and increased endometrial flow. Future studies are needed to assess the clinical impact of these findings.

Embolização Arterial Para Tratamento De Mioma Uterino: Uma Revisão Da Literatura.

“…O último estudo brasileiro analisado evidenciou que, após a EAU, houve um significativo aumento do sinal em T2 (inferindo maior grau de hidratação ou processo inflamatório tecidual) e maior realce pós-contraste (inferindo maior afluxo sanguíneo) no endométrio. Esses achados podem abrir uma nova frente de estudos sobre as alterações endometriais relacionadas à EAU, pois seria possível, porém ainda não comprovado, que um endométrio mais vascularizado tenha maior chance de possibilitar uma gestação saudável (JACOBS et al, 2013).…”