Genital / Reproductive system female, Interventional vascular, MR, Embolisation, Treatment effects, Neoplasia
E. Y. Auyoung, L. Ratnam, R. Das, S. M. Ameli, L. Mailli; London/UK
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 1 - 2.4 mm,
and (b) a maximum fibroid diameter greater than 5.1 cm,
there is a high likelihood of migration of the fibroid.
We identified these features in all 13 of the migrated dominant intramural fibroids in our study,
but in none of the non-migrating group.
These parameters were,
met in all non-dominant intramural fibroids we identified in our study images.
It has previously been postulated that fibroids with a portion of its circumference touching the endometrium can be expelled  however,
our study shows that having a short distance to the endometrium,
in addition to a large fibroid diameter,
also predisposes an intramural fibroid to migrate into the endometrial wall,
or entirely through the wall and be expelled into the vaginal canal.
By using simple measurements on an MR image prior to UAE,
we can anticipate this passage of fibroid tissue and educate patients to the consequences of the complication.