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CardioVascular and Interventional Radiology

, Volume 42, Issue 2, pp 186–194 | Cite as

Evaluation of Uterine Contractility by Magnetic Resonance Imaging in Women Undergoing Embolization of Uterine Fibroids

  • Vinicius Adami Vayego FornazariEmail author
  • Denis Szejnfeld
  • Jacob Szejnfeld
  • Claúdio Emilio Bonduki
  • Stela Adami Vayego
  • Suzan Menasce Goldman
Clinical Investigation Arterial Interventions
Part of the following topical collections:
  1. Arterial Interventions

Abstract

Purpose

To assess uterine contractility using ultrafast magnetic resonance imaging (cine MRI) before and after uterine fibroid embolization (UFE).

Materials and Methods

This is a prospective study of uterine contractility in 26 patients (age 30–41 years) undergoing UFE for symptomatic uterine fibroids. Cine MRI was performed before and 6 months after UFE. Two radiologists evaluated uterine contractility and classified it as absent, ordered, or disordered. Patients were then grouped into three distinct patterns of progression: unchanged contractility (group A), modified contractility (B), and loss of contractility (C). These findings were then confronted with factors that might have interfered with uterine contractility pattern (uterine volume, location of dominant fibroid, fibroid/myometrium index, and fibroid necrosis pattern).

Results

Of the 26 patients, 8 (30.7%) had no contractility before the procedure, while 18 (69.2%) exhibited some form of contractility (11 [61%] ordered, 7 [39%] disordered). All 8 patients who had no contractility at baseline exhibited contractility after UFE (5 ordered, 3 disordered). Of the 11 who had ordered contractility at baseline, 9 remained ordered and 2 lost contractility after UFE. Of the 7 with disordered contractility at baseline, 1 remained disordered, 5 progressed to ordered contractility, and 1 lost contractility. Overall, 10 patients (38%) had no change in contractility after UFE (group A), 13 (50%) had a positive change (group B), and 3 (11%) lost contractility (group C). The potential interference factors assessed had no statistically significant effect in any group.

Conclusion

In women of reproductive age with symptomatic fibroids, uterine contractility improved significantly after UFE.

Level of Evidence

Level 3—non-randomized controlled cohort/follow-up study.

Keywords

Uterine fibroid Therapeutic embolization Dynamic MRI Uterine peristalsis Infertility Sperm transport 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

For this type of study consent for publication is not required. This study was registered in the National Information System on Research Ethics Involving Human Beings (Sistema Nacional de Informação Sobre Ética em Pesquisa envolvendo Seres Humanos, SISNEP) and approved by the Research Ethics Committee/Plataforma Brasil (CAAE: 22039914.5.0000.5505).

Supplementary material

270_2018_2053_MOESM1_ESM.mov (2.4 mb)
Supplementary material—Video 1. Sagittal cine magnetic resonance (MR) images (ultrafast sequence), absence of uterine pathology showing ordered uterine peristalsis with cervico-fundal direction. (MOV 2501 kb)
270_2018_2053_MOESM2_ESM.mov (1.1 mb)
Supplementary material—Video 2. Sagittal cine magnetic resonance (MR) images (ultrafast sequence), presence diffuse submucosal myoma, of before uterine fibroid embolization (UFE) showing ordered uterine peristalsis. (MOV 1094 kb)
270_2018_2053_MOESM3_ESM.mov (1.4 mb)
Supplementary material—Video 3. Sagittal cine magnetic resonance (MR) (ultrafast sequence) images, obtained 6 months after uterine fibroid embolization (UFE), showing maintained ordered uterine peristalsis (group A—unchanged contractility pattern). (MOV 1481 kb)
270_2018_2053_MOESM4_ESM.mov (1.9 mb)
Supplementary material—Video 4. Before uterine fibroid embolization (UFE). Sagittal magnetic resonance imaging (MRI) (ultrafast sequence) showing a submucosal fibroid and absence of uterine contractility. (MOV 1941 kb)
270_2018_2053_MOESM5_ESM.mov (1.2 mb)
Supplementary material—Video 5. Sagittal cine MR images (ultrafast sequence), obtained 6 months after uterine fibroid embolization (UFE), showing new-onset ordered uterine peristalsis (group B—positive change in contractility). (MOV 1208 kb)
270_2018_2053_MOESM6_ESM.mov (2.1 mb)
Supplementary material—Video 6. Sagittal cine MR images (ultrafast sequence), obtained before uterine fibroid embolization (UFE), showing ordered uterine peristalsis. (MOV 2116 kb)
270_2018_2053_MOESM7_ESM.mov (1.6 mb)
Supplementary material—Video 7. Sagittal cine MR images (ultrafast sequence), obtained 6 months after uterine fibroid embolization (UFE), showing absence of uterine contractility (group C—loss of contractility). (MOV 1669 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Vinicius Adami Vayego Fornazari
    • 1
    Email author
  • Denis Szejnfeld
    • 1
  • Jacob Szejnfeld
    • 2
  • Claúdio Emilio Bonduki
    • 3
  • Stela Adami Vayego
    • 4
  • Suzan Menasce Goldman
    • 2
  1. 1.Interventional Radiology and Endovascular SurgeryUniversidade Federal de São Paulo (UNIFESP)São PauloBrazil
  2. 2.Department of Diagnostic Imaging (DDI), Escola Paulista Medicina (EPM)UNIFESPSão PauloBrazil
  3. 3.Outpatient Clinics of Arterial Embolization of Uterine Myoma and Cardiovascular Diseases and Thromboembolism, Gynecological Endocrinology Course, Department of Gynecology, EPMUNIFESPSão PauloBrazil
  4. 4.Department of StatisticsUniversidade Federal do Paraná (UFPR)CuritibaBrazil

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