Utility of MRI Before and After Uterine Fibroid Embolization: Why to Do It and What to Look For

Kirby, John M.; Burrows, D. A.; Haider, Ehsan; Maizlin, Zeev V.; Midia, Mehran

doi:10.1007/s00270-010-0029-2

Cited by 47 publications

(29 citation statements)

References 65 publications

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“…Fibroids that show infarction prior to embolization are less likely to shrink after treatment. 3D contrast-enhanced MRA has been shown to be useful for mapping the pelvic vasculature including the ovarian arteries and to identify the optimal tube angle to facilitate catheterization of the uterine arteries during embolization [7].…”

Section: Pre-treatment Imagingmentioning

confidence: 99%

“…In addition, MRI criteria used for the selection of suitable UAE patients are reported to show good inter-and intra-observer reproducibility [6]. Findings on MRI that are considered important in determining the suitability for UAE treatment are the size of the uterus and the fibroids, the number and location of the fibroids, the presence of pedunculated fibroids, signal intensity of fibroids on T1-and T2-weighted images, viability of the fibroids, the presence or absence of adenomyosis and coincidental pathologies that may change patient management [6][7][8].…”

Section: Pre-treatment Imagingmentioning

confidence: 99%

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Uterine Artery Embolization for Symptomatic Leiomyomata

Overhagen

Reekers

2014

Cardiovasc Intervent Radiol

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Section: Pre-treatment Imagingmentioning

confidence: 99%

Section: Pre-treatment Imagingmentioning

confidence: 99%

Uterine Artery Embolization for Symptomatic Leiomyomata

Overhagen

Reekers

2014

Cardiovasc Intervent Radiol

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“…Multiple papers have recommended that women with nonenhancing fibroids should be excluded from UAE due to anticipated minimal response in terms of size reduction [6][7][8][9][10], though there is a lack of studies directly comparing outcomes of enhancing vs nonenhancing fibroids. One retrospective study with 94 patients described the incidence of non-enhancing fibroids and recommended against their embolization, but did not report if the non-enhancing fibroids actually had poorer response [7].…”

Section: Introductionmentioning

confidence: 99%

“…Through the use of Magnetic Resonance Imaging (MRI), fibroids are readily identified and monitored after UAE. Fibroids are typically hypointense on T2 and enhance following the intravenous administration of gadolinium due to ample blood supply [6].…”

Section: Introductionmentioning

confidence: 99%

MRI enhancement predicting fibroid volume reduction to uterine artery embolization

Deipolyi¹

2017

Front WomensHealt

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Objectives: Fibroid non-enhancement is considered a relative contraindication to uterine artery embolization (UAE) for symptomatic fibroids. The purpose was to assess the impact of UAE on non-enhancing fibroids and to determine imaging predictors of fibroid shrinkage. Materials and methods:Retrospective review of all women who underwent UAE for symptomatic fibroids (5/09-7/14) and had follow-up MRI 6 months after UAE were included. There were 59 fibroids (5, non-enhancing; 54, enhancing) among 18 women with a mean age of 46 (range 40-53) years. All fibroids were assessed for size, position, enhancement on subtraction images, and Apparent Diffusion Constant (ADC). Results:Enhancing fibroids had an average decrease in diameter by 19± 3%, not significantly different that non-enhancing fibroids which decreased by 23± 6% (p=0.49). Multiple linear regression with percent change in fibroid diameter as the dependent variable and patient age, fibroid position, and pre-UAE fibroid diameter, enhancement, and ADC as independent variables, showed that ADC (p=0.04) and pre-UAE diameter (p=0.03) were the only significant independent variables. Conclusion:Pre-UAE size and ADC, but not contrast enhancement, predicted fibroid diameter reduction. Enhancing and non-enhancing fibroids had similar size reduction after UAE. Non-enhancement should not be considered a contraindication to UAE.

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“…Embolization of these end arterial branches ultimately results in infarction, coagulative necrosis, and eventual shrinkage of the targeted leiomyomas (7) . Owing to higher accuracy in assessing the size, number and location of uterine leiomyomas, Magnetic resonance imaging (MRI) is the preferable method over transvaginal 3008 US in the pre-and post-procedural assessment for UAE (8) . Moreover, MRI is more sensitive than US in diagnosing and excluding further causes of pelvic pain such as adenomyosis or endometriosis.…”

Section: Introductionmentioning

confidence: 99%

Measurement of Uterine Leiomyomata Volume Pre and Post Uterine Artery Embolization Aided by MRI

Aly

Abdullah²,

Botros³

2018

The Egyptian Journal of Hospital Medicine

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Background: uterine fibroid embolization (UFE) is now evolving to be the first-line treatment for symptomatic uterine leiomyomata alongside the conventional surgical treatment of hysterectomy and myomectomy. Cochrane review comprises six RCTs comparing UAE versus hysterectomy or myomectomy for management of symptomatic leiomyomata where UFE had similar short and midterm outcomes, inclusive of symptomatic relief, quality of life and patient satisfaction, while benefiting from uterine preservation, shorter hospital stay and a faster recovery before resuming ordinary life activities. These benefits are in line with the minimally invasive nature of the embolization procedures. Aim of the Work: t this study aimed to review and illustrate the role of MR imaging in the pre-and post-procedural assessment for uterine fibroid patients undergoing uterine artery embolization. Patients and Methods: the current study was carried out in Radiodiagnosis Department, Faculty of Medicine, Ain shams University and specialized private radiology centers during the period between April 2017 and December 2017. It included 30 patients that were referred from gynecology clinic with their ultrasonographic reports to Radiodiagnosis Department, body imaging unit with a view to carry-out pelvic MRI with contrast. Results: imaging follow-up via pelvic MRI with contrast was obtained in 30 patients at 3, 6 months after treatment. The mean uterine volume was reduced by 25% (standard deviation was SD 0.03763) 3 months after treatment and was further reduced by a mean of 30% (SD 0.02638) by six months after treatment. Post-procedural subtraction MRI revealed mean myoma enhancement to be 5.6 + 0.5 SI in contrast to 133.4 + 18.3 SI prior to UFE. The mean dominant fibroid volume reduced by 34 % (SD 0.09247) after 3 months, 44 % (SD 0.05994) after 6 months. A cumulative reduction in both uterine and dominant leiomyoma mean volume from baseline to 6 months post -UAE was evident with significant interval changes between 3, 6 months follow up (p 0.000) Conclusion: the MRI findings following UAE vary with the interval from embolization and success of the procedure. MRI with its multiplanar capabilities was typically employed to evaluate the uterus following UAE for fibroid infarction, size reduction, location change, persistent enhancement, fibroid recurrence, changes in adenomyosis, and unexpected complications that may require surgical intervention or identify women who would benefit from repeated UAE. Recommendations: further studies on a larger scale of patients are needed to confirm the results obtained by this work.

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Utility of MRI Before and After Uterine Fibroid Embolization: Why to Do It and What to Look For

Cited by 47 publications

References 65 publications

Uterine Artery Embolization for Symptomatic Leiomyomata

Uterine Artery Embolization for Symptomatic Leiomyomata

MRI enhancement predicting fibroid volume reduction to uterine artery embolization

Measurement of Uterine Leiomyomata Volume Pre and Post Uterine Artery Embolization Aided by MRI

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