Long-term results of symptomatic fibroids treated with uterine artery embolization: In conjunction with MR evaluation

Man Deuk Kim, Kim MD, Hyun Seok Lee, Lee HS, Mee Hwa Lee, Lee MH, Kim HJ, Hee Jin Kim, Han Jo Kim, Cho JH, Jin Ho Cho, Sun Hee Cha, Sun Hee, Cha SH
European journal of radiology · 2008 · vol. 73(2) , pp. 339–344 · doi:10.1016/j.ejrad.2008.10.040 · PMID:19084365 · W2161164689
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This study evaluated the long-term outcomes of symptomatic uterine fibroids treated with uterine artery embolization, incorporating MR imaging for assessment.

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Abstract

ObjectiveThe aim of the present study is to determine long-term clinical efficacy of uterine fibroid embolization (UFE) for symptomatic fibroids in conjunction with MR evaluation.Materials and methodsSixteen patients with a follow-up period of 4 years or longer were analyzed retrospectively. Ages ranged from 27 to 45 (mean 39.5) years. Mean follow-up periods were 5.8 years (range: 4.1-6.9 years). The symptom changes, in terms of menorrhagia and dysmenorrhea and bulk-related symptoms, were assessed. The primary embolic agent was polyvinyl alcohol particle (250-710microm). All patients underwent preprocedural and long-term follow up MR imaging. Uterine volumes were calculated using MRI.ResultsSymptom improvements were reported for menorrhagia (8/9, 88.9%), dysmenorrhea (5/5, 100%), and bulk-related symptoms (7/9, 77.8%) at long-term follow up. Two patients (12.5%) had symptom recurrences at long-term follow-up. Tumor regrowth from incomplete infarction was a cause of recurrence in one patient and newly developed leiomyomas in the other one. One patient underwent hysterectomy because endometriosis developed 4 years after UFE. Of the 14 necrotic myomas on short-term follow up MR after UFE, eight (57.1%) demonstrated maintaining necrosis with further shrinkage and six (42.9%) were no longer visualized on long-term follow up MR images. Overall, the mean volume reduction rates of the predominant fibroid and uterus were 80.5%, 36.7% at long-term follow up, respectively.ConclusionUFE is an effective treatment for symptomatic fibroids with an acceptable long-term success rate. Long-term MR imaging after UFE revealed persistent necrotic fibroid, non-visualization of fibroids and tumor regrowth when incompletely infarcted.

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MeSH descriptors

Leiomyoma Leiomyoma Magnetic Resonance Imaging Uterine Artery Embolization Uterine Neoplasms Uterine Neoplasms Adult Female Humans Leiomyoma Longitudinal Studies Magnetic Resonance Imaging Male Middle Aged Prognosis Treatment Outcome Uterine Artery Embolization Uterine Neoplasms

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