Predictive factors for pelvic magnetic resonance in response to arterial embolization of a uterine leiomyoma

Abstract

OBJECTIVE:Minimally invasive methods are used as alternatives to treat leiomyomas and include uterine artery embolization, which has emerged as a safe, effective method. This study aims to evaluate the magnetic resonance imaging predictors for a reduction in leiomyoma volume in patients undergoing uterine artery embolization.METHODS:This prospective longitudinal study was performed at a university hospital. We followed 50 symptomatic premenopausal women with uterine leiomyomas who underwent uterine artery embolization. We examined 179 leiomyomas among these patients. Magnetic resonance imaging was performed one month before and six months after uterine artery embolization. Two radiologists who specialized in abdominal imaging independently interpreted the images. Main Outcome Measures: The magnetic resonance imaging parameters were the uterus and leiomyomas volumes, their localizations, contrast perfusion pattern and node-to-muscle ratio.RESULTS:Six months after treatment, the average uterine volume reduction was 38.91%, and the leiomyomas were reduced by 55.23%. When the leiomyomas were submucosal and/or had a higher node-to-muscle ratio in the T2 images, the volume reduction was even greater (greater than 50%). Other parameters showed no association.CONCLUSIONS:We conclude that symptomatic uterine leiomyomas in patients undergoing uterine artery embolization exhibit volume reductions greater than 50% by magnetic resonance imaging when the leiomyomas are submucosal and/or had a high node-to-muscle ratio in the T2 images.

Improvement in parameters of quality of life and uterine volume reduction after uterine fibroid embolization

“…(9,19,21,23) There was a 37.1% reduction in uterine volume in our sample, slightly lower than values reported in other Brazilian and international studies. (23,(26)(27)(28)(29) Even with a smaller reduction in uterine volume, quality of life improvement scores were comparable to those of studies that had a greater reduction in uterine volume. (30) As reported in previous studies, (9,23) there was no evidence of correlation between uterine volume changes and quality of life scores after UFE as well.…”

Magnetic Resonance-Guided High-Intensity Focused Ultrasound Ablation of Uterine Fibroids—Efficiency Assessment with the Use of Dynamic Contrast-Enhanced Magnetic Resonance Imaging and the Potential Role of the Administration of Uterotonic Drugs

“…The results of the analysis showed a good correlation between the type of UF determined on the basis of the gain curve and the NPV value. Highly vascularized lesions were more effectively treated by UAE than poorly vascularized ones [ 48 ]. The above studies suggest that UFs that are enhanced to a smaller extent than normal myometrial tissue are poorly vascularized, so they can be treated more effectively with MR-HIFU.…”

Development of a Model for the Prediction of Treatment Response of Uterine Leiomyomas after Uterine Artery Embolization

“…These results are consistent with the present study. One study showed that the ratio between the uterine leiomyoma and skeletal muscle was higher when the treatment response was greater 17.…”

“…To more objectively compare leiomyomas between patients, using a common denominator was necessary. Therefore, the T2 leiomyoma:muscle ratio was used to predict reduction of uterine leiomyoma size 17.…”