Aims and objectives
Uterine artery embolisation (UAE) is an efficacious and less invasive alternative to surgery that results in infarction,
and eventual shrinkage of uterine fibroids [1,2].
The procedure is generally associated with a low risk of complications,
but in approximately 2.5% of patients,
there is passage of the fibroid tissue through the uterine wall,
resulting in symptoms of pain,
or bleeding .
In some cases,
the fibroid is fully expelled,
but in others,
the fibroid may simply travel across the uterine wall,
Methods and materials
Patient selection: A retrospective study identified consecutive non-randomised patients (mean age: 45 years; age range: 30-60) who referred for UAE for symptomatic fibroids at one centre,
in one year.
As per recommended UAE standard protocol,
all patients were required to have underwent a pre-procedural MRI and a post-procedural MRI,
six months after embolization.
Patients without these images were excluded from the study and thus a total study group of 64 women were identified.
Data acquisition: All MRI scans were performed using a 1.5 Tesla (T)...
Of the 64 dominant fibroids,
35 (55%) were intramural,
and of these 13 (37%) either migrated migrated to become submucosal (n=8),
partially expelled (n=2),
or completely expelled (n=3).
Table 1summarises the parameters measured in each dominant intramural fibroid.
statistical significance wasachievedin the pre-procedural mean minimal endometrial distance and mean maximal fibroid diameter between migrating and non-migrating intramural fibroids.
Upon re-assessing the images for migrating non-dominant fibroids,
we identified four intramural fibroids that had migrated - their measurements are summarised in Table 2.
The expulsion of fibroid tissue is understandably distressing to patients,
especially if not expected.
after undergoing a treatment intended to resolve that very issue,
can be frustrating.
Our study identified specific fibroid characteristics on a pre-procedural MRI that can predict potential migration of an intramural fibroid,
the symptoms associated with the passage of a fibroid through the uterine wall.
According to our findings,
if an intramural fibroid on the pre-procedural MRI has both,
(a) a minimum distance to the endometrium between...
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