Aims and objectives
To evaluate fibroid size using ultrasonography (US) and magnetic resonance imaging (MRI) after uterine arteries embolization(UAE) of leiomyoma.
Methods and materials
From 2008 to 2017 to May 1023 women with symptomatic leiomyoma were treated by bilateral transcatheter UAE.Angiography and embolization were performed using 5F Cobra and Roberts uterine catheters by 355-1000µm of PVA particles.The size of particles depended on uterine arteries diameter and anastomosis between uterine and ovary arteries.
Mean age 35,5 years (range – 20-52).
51% of patients had dominant fibroid’s size more than 8cm and different location,
multiple fibroids occurred in 71% cases.
All patients underwent US and MRI before and after UAE.
Analysis...
Results
The moderate reduction of leiomyoma’s size was observed in one month after UAE.
Decrease of fibroid size determined by US – 18,4%,
by MRI – 17,3%,
in 1 month.
Following reduction of fibroid’s size was in 3 months by US – 40,7%,
by MRI – 42,9%,
in 6 months by US – 60,4%,
by MRI – 61,8%,
in 12 months by US – 72,5%,
by MRI – 74,7%,
in 24 months by US – 70,8%,
by MRI – 72,2%.
Doppler US-control showed blood flow decrease...
Conclusion
UAE is an effective,
minimal-invasive kind of leiomyoma’s treatment.
MRI and US are the modalities that can accurately estimate fibroid’s changes and blood flow in uterine arteries.
The tendency of fibroid's shrinkage after UAE is well-defined in period from 1M to 24M.
After UAE the blood supply of myometrium is restored according to US Doppler data in the period from 1M to 3M.
References
1. 1. Lopes HI,
Sá MI,
Rodrigues RM.
Pregnancy afteruterine artery embolization: a case report in a woman with leiomyomata. Case Rep Obstet Gynecol.
2015;2015:235312.
2. Tang Y,
Chen C,
Duan H,
Ma B,
Liu P.
Low vascularity predicts favourable outcomes inleiomyomapatients treated withuterine artery embolization. Eur Radiol.
2016 Oct;26(10):3571-9.
3. Torre A,
Fauconnier A,
Kahn V,
Limot O,
Bussierres L,
Pelage JP.
Fertility afteruterine artery embolizationfor symptomatic multiplefibroidswith no other infertility factors. Eur Radiol.
2017 Jul;27(7):2850-2859.