Learning objectives
To explain algorithm of uterine fibroid (UF) diagnostic assessment and follow-up management after embolization.
To illustrate diversity of MRI characteristics of uterine fibroids.
To demonstrate pictorial examples of UF before and after embolization emphasizing what should be reported.
Background
Uterine fibroids (UF),
also referred to as myomas or leiomyomas,
are the most common benign tumors of female pelvis that occur in 20-30% of women in reproductive age.
UF may be single or multiple,
variable in size.
These tumors are composed of smooth muscle cells with variable amounts of fibrous connective tissue.
They are typically asymptomatic but when presented with symptoms(20-50 %) like abnormal uterine bleeding (menometrorrhagia),
pelvic pain or pressureon adjacent organs they may be treated with uterine fibroid embolization (UFE).
After initial examination...
Findings and procedure details
Pelvic MRI is a method of choice for confirmation and characterization of uterine fibroids.
MRI protocol varies among institutions,
mostly in terms of the plane selection,
however,
required sequences are T2WI in three planes,
T1WI with and without fat saturation and dynamic postcontrast T1WI sequences.Diffusion sequences (DWI and ADC) are also acquired but of lesser significance in diagnosis of leiomyomas.
In this educational exhibit we will try to accentuate what is important for diagnostic radiologist to report and explain what information the gynecologist and interventional...
Conclusion
During the past two decades UFE has emerged as a safe and effective treatment option for uterine fibroids (UFs).
MRI provides information that both gynaecologist and interventional radiologist need to make the right decision in UF management,
helps them to determine who is an appropriate candidate for UFE,detects coexistent pelvic pathology and monitors postprocedural success.
Personal information
Ivana Kavelj,
MD
Radiology resident
Department of diagnostic and interventional radiology
UHC Sisters of Mercy (KBC Sestre milosrdnice)
Vinogradska cesta 29
Zagreb 10000
Croatia
E-mail:
[email protected]
References
1.Deshmukh SP,
Gonsalves CF,
Guglielmo FF,
Mitchell DG.
Role of MR imaging of uterine leiomyomas before and after embolization.
Radiographics 2012 Oct;32(6):E251-E281.
doi: 10.1148/rg.326125517.
2.Murase E,
Siegelman ES,
Outwater EK,
Perez-Jaffe LA,
Tureck RW.Uterine leiomyomas: histopathologic features,
MR imaging findings,
differential diagnosis,
and treatment. Radiographics.
1999 Sep-Oct;19(5):1179-1197.
3.Cura M,
Cura A,
Bugnone A.
(2006).
Role of magnetic resonance imaging in patient selection for uterine artery embolization.
Acta Radiologica,
47(10),
1105–1114.
https://doi.org/10.1080/02841850600965047.
4.
Duc NM,
Huy HQ.Effect of magnetic resonance imaging characteristics on uterine fibroid treatment....