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Uterine artery embolization: pre- and post-procedural evaluation using magnetic resonance imaging

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Abdominal Imaging Aims and scope

Abstract

Magnetic resonance (MR) imaging has become the preferred method in assessing the uterus and pelvis prior to and following uterine artery embolization (UAE). The multiplanar imaging capabilities, increased spatial and contrast resolution, anatomic detail and assessment of fibroid viability that MR provides over ultrasound allows for accurate pre-treatment planning and post-treatment assessment. The purpose of this article is to demonstrate the use of MR in the selection of patients, anatomic evaluation and procedural planning before UAE, describe the use of MR in evaluating treatment response after UAE and illustrate the use of MR in identifying post-UAE complications. An understanding of these principles is essential in guiding appropriate therapy, determining treatment effectiveness and identifying associated complications before and after UAE.

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References

  1. Pron G, Bennett J, Common A, et al. (2003) The Ontario uterine fibroid embolization trial. Part 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids. Fertil Steril 79(1):120–127

    Article  PubMed  Google Scholar 

  2. Spies JB (2003) Uterine artery embolization for fibroids: understanding the technical causes of failure. J Vasc Interv Radiol 14(1):11–14

    Article  PubMed  Google Scholar 

  3. Walker WJ, Pelage JP (2002) Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow up. BJOG 109(11):1262–1272

    Article  PubMed  CAS  Google Scholar 

  4. Ravina JH, Herbreteau D, Ciraru-Vigneron N, et al. (1995) Arterial embolisation to treat uterine myomata. Lancet 346(8976):671–672

    Article  PubMed  CAS  Google Scholar 

  5. McLucas B, Adler L, Perrella R (2001) Uterine fibroid embolization: nonsurgical treatment for symptomatic fibroids. J Am Coll Surg 192(1):95–105

    Article  PubMed  CAS  Google Scholar 

  6. Parker WH (2007) Uterine myomas: management. Fertil Steril 88(2):255–271

    Article  PubMed  Google Scholar 

  7. Goodwin SC, McLucas B, Lee M, et al. (1999) Uterine artery embolization for the treatment of uterine leiomyomata midterm results. J Vasc Interv Radiol 10(9):1159–1165

    Article  PubMed  CAS  Google Scholar 

  8. Spies JB, Ascher SA, Roth AR, et al. (2001) Uterine artery embolization for leiomyomata. Obstet Gynecol 98(1):29–34

    Article  PubMed  CAS  Google Scholar 

  9. Goodwin SC, Spies JB (2009) Uterine fibroid embolization. N Engl J Med 361(7):690–697

    Article  PubMed  CAS  Google Scholar 

  10. deSouza NM, Williams AD (2002) Uterine arterial embolization for leiomyomas: perfusion and volume changes at MR imaging and relation to clinical outcome. Radiology 222(2):367–374

    Article  PubMed  Google Scholar 

  11. Omary RA, Vasireddy S, Chrisman HB, et al. (2002) The effect of pelvic MR imaging on the diagnosis and treatment of women with presumed symptomatic uterine fibroids. J Vasc Interv Radiol 13(11):1149–1153

    Article  PubMed  Google Scholar 

  12. Ascher SM, Arnold LL, Patt RH, et al. (1994) Adenomyosis: prospective comparison of MR imaging and transvaginal sonography. Radiology 190(3):803–806

    PubMed  CAS  Google Scholar 

  13. Del Frate C, Girometti R, Pittino M, et al. (2006) Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. Radiographics 26(6):1705–1718

    Article  PubMed  Google Scholar 

  14. Naguib NN, Nour-Eldin NE, Hammerstingl RM, et al. (2008) Three-dimensional reconstructed contrast-enhanced MR angiography for internal iliac artery branch visualization before uterine artery embolization. J Vasc Interv Radiol 19(11):1569–1575

    Article  PubMed  Google Scholar 

  15. Pelage JP, Guaou NG, Jha RC, Ascher SM, Spies JB (2004) Uterine fibroid tumors: long-term MR imaging outcome after embolization. Radiology 230(3):803–809

    Article  PubMed  Google Scholar 

  16. Jha RC, Ascher SM, Imaoka I, Spies JB (2000) Symptomatic fibroleiomyomata: MR imaging of the uterus before and after uterine arterial embolization. Radiology 217(1):228–235

    PubMed  CAS  Google Scholar 

  17. Naguib NN, Nour-Eldin NE, Lehnert T, et al. (2009) Uterine artery embolization: optimization with preprocedural prediction of the best tube angle obliquity by using 3D-reconstructed contrast-enhanced MR angiography. Radiology 251(3):788–795

    Article  PubMed  Google Scholar 

  18. Margau R, Simons ME, Rajan DK, et al. (2008) Outcomes after uterine artery embolization for pedunculated subserosal leiomyomas. J Vasc Interv Radiol 19(5):657–661

    Article  PubMed  Google Scholar 

  19. Katsumori T, Akazawa K, Mihara T (2005) Uterine artery embolization for pedunculated subserosal fibroids. AJR Am J Roentgenol 184(2):399–402

    Article  PubMed  Google Scholar 

  20. Toor SS, Tan KT, Simons ME, et al. (2008) Clinical failure after uterine artery embolization: evaluation of patient and MR imaging characteristics. J Vasc Interv Radiol 19(5):662–667

    Article  PubMed  Google Scholar 

  21. Ghai S, Rajan DK, Benjamin MS, Asch MR, Ghai S (2005) Uterine artery embolization for leiomyomas: pre- and postprocedural evaluation with US. Radiographics 25(5):1159–1172 (discussion 73–76)

    Article  PubMed  Google Scholar 

  22. Katsumori T, Nakajima K, Mihara T (2003) Is a large fibroid a high-risk factor for uterine artery embolization? AJR Am J Roentgenol 181(5):1309–1314

    Article  PubMed  Google Scholar 

  23. Firouznia K, Ghanaati H, Sanaati M, Jalali AH, Shakiba M (2008) Uterine artery embolization in 101 cases of uterine fibroids: do size, location, and number of fibroids affect therapeutic success and complications? Cardiovasc Interv Radiol 31(3):521–526

    Article  Google Scholar 

  24. Kirby JM, Burrows D, Haider E, Maizlin Z, Midia M (2011) Utility of MRI before and after uterine fibroid embolization: why to do it and what to look for. Cardiovasc Interv Radiol 34(4):705–716

    Article  Google Scholar 

  25. Yamashita Y, Torashima M, Takahashi M, et al. (1993) Hyperintense uterine leiomyoma at T2-weighted MR imaging: differentiation with dynamic enhanced MR imaging and clinical implications. Radiology 189(3):721–725

    PubMed  CAS  Google Scholar 

  26. Harman M, Zeteroglu S, Arslan H, Sengul M, Etlik O (2006) Predictive value of magnetic resonance imaging signal and contrast-enhancement characteristics on post-embolization volume reduction of uterine fibroids. Acta Radiol 47(4):427–435

    Article  PubMed  CAS  Google Scholar 

  27. Burn PR, McCall JM, Chinn RJ, et al. (2000) Uterine fibroleiomyoma: MR imaging appearances before and after embolization of uterine arteries. Radiology 214(3):729–734

    PubMed  CAS  Google Scholar 

  28. Jha RC, Takahama J, Imaoka I, et al. (2003) Adenomyosis: MRI of the uterus treated with uterine artery embolization. AJR Am J Roentgenol 181(3):851–856

    Article  PubMed  Google Scholar 

  29. Tamai K, Koyama T, Umeoka S, et al. (2006) Spectrum of MR features in adenomyosis. Best Pract Res Clin Obstet Gynaecol 20(4):583–602

    Article  PubMed  Google Scholar 

  30. Volkers NA, Hehenkamp WJ, Spijkerboer AM, et al. (2008) MR reproducibility in the assessment of uterine fibroids for patients scheduled for uterine artery embolization. Cardiovasc Intervent Radiol 31(2):260–268

    Article  PubMed  Google Scholar 

  31. Siskin GP, Tublin ME, Stainken BF, Dowling K, Dolen EG (2001) Uterine artery embolization for the treatment of adenomyosis: clinical response and evaluation with MR imaging. AJR Am J Roentgenol 177(2):297–302

    Article  PubMed  CAS  Google Scholar 

  32. Kim MD, Kim S, Kim NK, et al. (2007) Long-term results of uterine artery embolization for symptomatic adenomyosis. AJR Am J Roentgenol 188(1):176–181

    Article  PubMed  Google Scholar 

  33. Sugimura K, Okizuka H, Imaoka I, et al. (1993) Pelvic endometriosis: detection and diagnosis with chemical shift MR imaging. Radiology 188(2):435–438

    PubMed  CAS  Google Scholar 

  34. Imaoka I, Wada A, Matsuo M, et al. (2003) MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management. Radiographics 23(6):1401–1421

    Article  PubMed  Google Scholar 

  35. Rha SE, Byun JY, Jung SE, et al. (2003) CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol 181(5):1369–1374

    Article  PubMed  Google Scholar 

  36. Leibsohn S, d’Ablaing G, Mishell DR Jr, Schlaerth JB (1990) Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol 162(4):968–974

    Article  PubMed  CAS  Google Scholar 

  37. Chrisman HB, Rajeswaran S, Dhand S, et al. (2009) Effect of postprocedural pelvic MR imaging on medical decision-making in women who have undergone uterine artery embolization. J Vasc Interv Radiol 20(7):977–980

    Article  PubMed  Google Scholar 

  38. Verma SK, Gonsalves CF, Baltarowich OH, et al. (2010) Spectrum of imaging findings on MRI and CT after uterine artery embolization. Abdom Imag 35(1):118–128

    Article  Google Scholar 

  39. Spies JB, Spector A, Roth AR, et al. (2002) Complications after uterine artery embolization for leiomyomas. Obstet Gynecol 100(5 Pt 1):873–880

    Article  PubMed  Google Scholar 

  40. Vashisht A, Studd J, Carey A, Burn P (1999) Fatal septicaemia after fibroid embolisation. Lancet 354(9175):307–308

    Article  PubMed  CAS  Google Scholar 

  41. Rajan DK, Beecroft JR, Clark TW, et al. (2004) Risk of intrauterine infectious complications after uterine artery embolization. J Vasc Interv Radiol 15(12):1415–1421

    Article  PubMed  Google Scholar 

  42. Kitamura Y, Ascher SM, Cooper C, et al. (2005) Imaging manifestations of complications associated with uterine artery embolization. Radiographics 25(Suppl 1):S119–S132

    Article  PubMed  Google Scholar 

  43. Verma SK, Bergin D, Gonsalves CF, et al. (2008) Submucosal fibroids becoming endocavitary following uterine artery embolization: risk assessment by MRI. AJR Am J Roentgenol 190(5):1220–1226

    Article  PubMed  Google Scholar 

  44. Gabriel H, Pinto CM, Kumar M, et al. (2004) MRI detection of uterine necrosis after uterine artery embolization for fibroids. AJR Am J Roentgenol 183(3):733–736

    Article  PubMed  Google Scholar 

  45. Torigian DA, Siegelman ES, Terhune KP, et al. (2005) MRI of uterine necrosis after uterine artery embolization for treatment of uterine leiomyomata. AJR Am J Roentgenol 184(2):555–559

    Article  PubMed  Google Scholar 

  46. Siddiqi AJ, Chrisman HB, Vogelzang RL, et al. (2006) MR imaging evidence of reversal of uterine ischemia after uterine artery embolization for leiomyomata. J Vasc Interv Radiol 17(9):1535–1538

    Article  PubMed  Google Scholar 

  47. Chrisman HB, Saker MB, Ryu RK, et al. (2000) The impact of uterine fibroid embolization on resumption of menses and ovarian function. J Vasc Interv Radiol 11(6):699–703

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Feinberg School of Medicine, Northwestern University, 676 North St. Clair, Suite 800, Chicago, IL, 60611, USA

    Nasir Siddiqui, Paul Nikolaidis, Nancy Hammond & Frank H. Miller

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  1. Nasir Siddiqui
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  2. Paul Nikolaidis
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  3. Nancy Hammond
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  4. Frank H. Miller
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Correspondence to Frank H. Miller.

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Siddiqui, N., Nikolaidis, P., Hammond, N. et al. Uterine artery embolization: pre- and post-procedural evaluation using magnetic resonance imaging. Abdom Imaging 38, 1161–1177 (2013). https://doi.org/10.1007/s00261-013-9990-y

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