Long-term MR Imaging after Uterine Artery Embolization for Symptomatic Adenomyosis

Purpose: We wanted to assess the long-term follow-up MR (LTFU-MR) imaging of adenomyosis that was treated with uterine artery embolization (UAE). Materials and Methods: From 1998 to 2000, 22 patients who underwent UAE for symptomatic adenomyosis were enrolled. The pattern of adenomyosis was divided into two categories: focal (n=14) and diffuse type (n=8). All the patients underwent contrast-enhanced MR imaging 3 months before embolization and over 3 years after embolization. The MR findings for the volume change and the existence and alteration of necrosis were analyzed. Results: In the focal adenomyosis, LTFU-MR revealed contrast enhancement in the completely necrotized area before in five out of seven patients and persistent necrosis with atrophy in the remaining two cases. In the six cases without necrosis, four showed global enlargement of the uterus. In the eight patients with diffuse adenomyosis, LTFU-MR revealed contrast enhancement in the necrotized area in four of the patients. Of the remaining four patients who had no necrosis, two showed global enlargement of the uterus. Conclusion: LTFU-MR revealed three common patterns: persistent necrosis or atrophy, viable tissue replacement in the previously necrotized area and global enlargements of the uterus.