Sonographic Findings Pre- and

Uterine artery embolization is emerging as a primary treatment for symptomatic uterine fibroids. This procedure is performed electively but occasionally is performed emergently in the setting of life-threatening hemorrhage. Most interventional radiologists performing this procedure use ultrasound or magnetic resonance imaging (MRI) for preprocedure evaluation and follow-up. Two case studies report the sonographic and color flow Doppler findings before, immediately after, and 3 months after uterine fibroid embolization (UFE) in an emergent UFE and an elective case. Angiographic and MRI correlation are also provided. Key words: uterine fibroid embolization, fibroid, embolization Uterine artery embolization is emerging as a primary treatment for symptomatic uterine fibroids. This procedure is performed electively but occasionally is performed emergently in the setting of life-threatening hemorrhage. Case Study 1 A 37-year-old woman presented to the emergency room with a massive vaginal hemorrhage. Serum B-hCG was negative. Evaluation by a gynecologist revealed a large lower uterine mass. A stat ultrasound revealed a 7 cm hypoechoic posterior inferior uterine mass that was felt to be consistent with a fibroid (Fig. 1). Color Doppler revealed the mass to be hypervascular (Fig. 2). Even though the endometrium and its relationship to the fibroid were not well seen, it was thought to be submucosal in nature because of the symptomatic bleeding. A vaginal pack was positioned by the gynecologist, and the patient was started on premarin. The patient received 4 units of packed red blood cells, and the bleeding appeared to stop. The patient was advised that a hysterectomy might be necessary if she rebled. She was not thought to be a candidate for a myomectomy. Interventional radiology