<b>Adenomyosis:</b> MRI of the Uterus Treated with Uterine Artery Embolization

Jha, Reena; Takahama, Junko; Imaoka, Izumi; Korangy, Shahin J; Spies, James B.; Cooper, Cirrelda; Ascher, Susan M.

doi:10.2214/ajr.181.3.1810851

Cited by 93 publications

(39 citation statements)

References 31 publications

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“…Although minimally invasive therapies such as implantation of a levonorgestrel intrauterine system (LNG-IUS) and endometrial ablation or resection have been used to manage uterine adenomyosis their success rates vary with the depth of uterine adenomyosis infiltration, and long-term results remain unclear [12,21,22]. Studies showing the effect of UAE for uterine adenomyosis mainly describe successful short-term results [13][14][15][16][17]. Midterm results of UAE for uterine adenomyosis are reported by some authors as being disappointing with a high rate of recurrence of clinical symptoms [23,24].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported symptomatic improvement after UAE in women with uterine leiomyomata and uterine adenomyosis, so investigators have proposed UAE for managing symptomatic uterine adenomyosis. Despite reports of successful short-term and midterm results of UAE for symptomatic uterine adenomyosis, there is still a paucity of longer follow-up results [13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Uterine Artery Embolization to Treat Uterine Adenomyosis with or without Uterine Leiomyomata: Results of Symptom Control and Health-Related Quality of Life 40 Months after Treatment

Froeling

Scheurig-Muenkler

Hamm

et al. 2011

Cardiovasc Intervent Radiol

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Uterine Artery Embolization to Treat Uterine Adenomyosis with or without Uterine Leiomyomata: Results of Symptom Control and Health-Related Quality of Life 40 Months after Treatment

Froeling

Scheurig-Muenkler

Hamm

et al. 2011

Cardiovasc Intervent Radiol

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“…These are caused by the activation of small, low-flow vascular circuits that are not detected at the time of treatment. The microcirculation of the myoma can be evaluated only with MR angiography and the use of contrast agents, techniques which are often very expensive and not always readily available [10].…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced ultrasound (CEUS) assessment of superselective uterine fibroid embolization (SUFE): Preliminary experience

Sconfienza

Lacelli

Gandolfo

et al. 2008

Journal of Ultrasound

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KEYWORDSFibroids; Therapeutic embolization; Ultrasonography; Contrast-enhanced ultrasonography.Abstract Purpose: The use of superselective uterine fibroid embolization (SUFE) requires imaging techniques that can be used to verify the success of the procedure. The purpose of our study was to analyze the potential value of pre-and post-treatment contrast-enhanced ultrasonography (CEUS) for assessing the outcome of SUFE and for posttreatment follow-up. Materials and methods: We studied twelve women undergoing SUFE for uterine fibroids. In those with multiple fibroids, only the three largest were considered in this study. A total of 21 lesions (size range 3.5e9.0 cm, mean 5.2 cm) were examined. Each myoma was examined immediately before and after SUFE (while the patient was still in the angiography room) with transabdominal CEUS performed after intravenous administration of a single bolus of contrast agent. The follow-up protocol included CEUS evaluation one month after treatment and CEUS plus dynamic magnetic resonance (MR) studies six months after treatment. Results: In 20/21 cases, postembolization CEUS revealed total fibroid devascularization. The remaining lesion (in a woman with multiple lesions) showed persistent vascularization after SUFE. These findings were all consistent with angiographic data. No recurrences were observed during the six-month follow-up. One patient reported the reappearance of symptoms 18 months after SUFE, and CEUS showed the persistence of intralesional vascularization. Conclusions: CEUS is effective for assessing the completeness of vascular occlusion following SUFE for uterine fibroids. CEUS findings correlate with clinical results observed one and six months after treatment. Compared with dynamic MR, CEUS is reliable and cost-effective.Sommario Obiettivi: L'introduzione della embolizzazione superselettiva dei miomi uterini (SUFE) in radiologia interventistica ha reso necessario lo studio di metodiche di imaging che consentano di definire correttamente il risultato terapeutico. Lo scopo di questo lavoro è di descrivere i reperti ottenuti tramite CEUS prima e dopo SUFE e di stabilire se la CEUS può giocare un ruolo nella valutazione dei risultati e nel follow up di questa procedura. Materiali e metodi: Abbiamo valutato tramite CEUS 21 miomi in 12 pazienti immediatamente prima e dopo la SUFE direttamente in sala angiografica. A causa della dimensione dei miomi (range 3.7e9.0 cm, media 5.2 cm), tutte le valutazioni sono state effettuate per via trans-addominale. In caso di miomatosi multipla, abbiamo valutato solo i tre miomi più grandi. In tutti i pazienti, è stato iniettato un singolo bolo di mezzo di contrasto. Il protocollo di follow up ha previsto una valutazione CEUS dopo un mese e una valutazione con CEUS e risonanza magnetica (RM) dopo sei mesi. Risultati: In 20/21 casi, la CEUS ha dimostrato una devascolarizzazione totale delle lesioni immediatamente dopo l'embolizzazione. In un caso di lesioni multiple, un fibroma ha mantenuto la propria vascolarizzazione. Questi risultati son...

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“…Les premières études suggèrent des taux de récidive à moyen terme de 5 à 10 % [41,51]. L'adénomyose associée aux fibromes ou isolée constitue également une cause de récidive clinique à moyen terme [54,55]. L'absence d'amélioration clinique et l'augmentation de taille après une embolisation de fibromes techniquement satisfaisante, doit faire évoquer, même si cela est exceptionnel, le diagnostic de sarcome utérin [56].…”

Section: éChec Ou Récidive Après Embolisationunclassified