Imaging Fibroids Pre and Post Uterine Artery Embolisation
Fibroids are common in women of reproductive age and non-surgical management with uterine artery embolisation for symptomatic patients is increasingly performed. In this chapter, the role of diagnostic radiology, in particular MRI, in the diagnosis, mapping and assessment of fibroid disease prior to embolisation is discussed. While ultrasound is readily available, MRI has been shown to be more accurate at characterising fibroids and defining their number and location. In particular fibroid vascularity prior to embolisation is well demonstrated with Gadolinium-enhanced MRI. Contraindications to embolisation such as pedunculated fibroids on a narrow stalk or non-vascular, degenerated fibroids are also readily identified with MRI. Following embolisation, early change in fibroid vascularity can be demonstrated which has a prognostic implication to long-term response. Post-embolisation appearances such as intra-fibroid gas, infection and fibroid passage are also discussed and demonstrated. Given that uterine artery embolisation is increasingly being performed, diagnostic radiologists therefore need to be familiar with pre-treatment diagnosis and assessment and typical post-embolisation appearances.
KeywordsUterine Artery Embolisation Uterine Sarcoma Abnormal Uterine Bleeding Endometrial Stromal Sarcoma Intramural Fibroid
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