Uterine Artery Embolization for Symptomatic Adenomyosis: A New Technical Development of the 1-2-3 Protocol and Predictive Factors of MR Imaging Affecting Outcomes

Kim MD, Man Deuk Kim, Kim YM, Yong Min Kim, Hyun Cheol Kim, Kim HC, Cho JH, Jung Hyun Cho, Kang HG, Hyung Gon Kang, Lee C, Chan Lee, Kim HJ, Hee Jin Kim, Han Jo Kim, Jong Tae Lee, Lee JT
Journal of vascular and interventional radiology : JVIR · 2011 · vol. 22(4) , pp. 497–502 · doi:10.1016/j.jvir.2011.01.426 · PMID:21377897 · W2066575085
article OA: green CC0 ⤵ 44 in-corpus citations
🔓 Open OA copy View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study details a novel 1-2-3 protocol for uterine artery embolization in adenomyosis and identifies MR imaging features that predict treatment outcomes.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

PurposeTo evaluate the safety and effectiveness of a new embolization technique named the 1-2-3 protocol to achieve complete necrosis of adenomyosis after uterine artery embolization (UAE) and to determine predictive factors on magnetic resonance (MR) imaging.Materials and methodsA total of 40 patients with adenomyosis without leiomyomas diagnosed on MR imaging were prospectively enrolled. They were subdivided into three categories based on MR signal intensity (SI) of the adenomyosis on T2-weighted imaging: dark, low, and heterogeneous SI or SI equal to that of the myometrium. Nonspherical polyvinyl alcohol particles were used in all cases, beginning with 150-250-μm particles and progressively increasing to 250-355-μm and then 355-500-μm particles to the endpoint. Patients were assessed for extent of devascularization on MR imaging and for durability of symptom control.ResultsOf the 40 patients who underwent UAE for adenomyosis with the 1-2-3 protocol, 33 (82.5%) exhibited complete necrosis of adenomyosis. All six patients with dark SI of adenomyosis exhibited complete necrosis (100%). Of the 28 patients with low SI of adenomyosis, 25 (89.3%) showed complete necrosis. Among the six patients with heterogenous SI or SI equal to that of myometrium, only two (33.3%) showed complete necrosis (P < .01). Of 16 patients with complete necrosis followed up to 18 months, none reported recurrent menorrhagia. Of the five patients without necrosis, only one had no symptoms at 18 months.ConclusionsUAE with the 1-2-3 protocol is safe and highly effective to achieve complete necrosis of adenomyosis. Dark SI of adenomyosis is the most favorable predictive factor for UAE on MR imaging, followed by low SI. Heterogenous SI or SI equal to that of the myometrium is an unfavorable predictive factor.

My notes (saved in your browser only)

Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Magnetic Resonance Imaging Polyvinyl Alcohol Uterine Artery Embolization Uterine Diseases Adult Endometriosis Endometriosis Endometriosis Female Humans Middle Aged Necrosis Particle Size Polyvinyl Alcohol Prospective Studies Recurrence Republic of Korea Time Factors Treatment Outcome

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (25)

Cited by (45)

Source provenance

europepmc
last seen: 2026-07-28T06:14:09.330459+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:16:48.482574+00:00
License: CC0 · commercial use OK