Abstract
Purpose
To retrospectively evaluate the relationship between the degree of infarction of uterine fibroids on enhanced MRI after embolization and long-term clinical outcomes.
Methods
During 92 months, 290 consecutive patients with symptomatic uterine fibroids were treated with embolization; 221 who underwent enhanced MRI before embolization and 1 week after embolization were included in this study. The infarction rates of all fibroid tissue were assessed using enhanced MRI after embolization. Patients were divided into three groups according to the infarction rates: group A (100% infarction, n = 142), group B (90–99% infarction, n = 74), group C (<90% infarction, n = 5). The cumulative rates of clinical outcomes were compared among groups using the Kaplan-Meier limited method.
Results
Group A had a significantly higher rate of symptom control than groups B and C. The cumulative rates of symptom control at 5 years were 93%, 71%, and 60% in groups A, B, and C, respectively. Group A had a significantly lower rate of gynecologic intervention after embolization than groups B and C. The cumulative rates of additional gynecologic intervention at 5 years were 3%, 15%, and 20% in groups A, B, and C, respectively.
Conclusions
The degree of infarction of uterine fibroids after embolization on enhanced MRI was related to long-term clinical outcomes. Complete infarction of all fibroid tissue can induce a higher rate of symptom control, with a lower rate of additional gynecologic intervention in the long term compared with incomplete infarction of fibroid tissue.
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References
Ravina JH, Herbreteau D, Ciraru-Vigneron N, et al. (1995) Arterial embolisation to treat uterine myomata. Lancet 346:671–672
Worthington-Kirsch R, Spies JB, Myers ER, et al. (2005) The Fibroid Registry for Outcomes Data (FIBROID) for uterine embolization: Short-term outcomes. Obstet Gynecol 106:52–59
Spies JB, Myers ER, Worthington-Kirsch R, et al. (2005) The Fibroid Registry: Symptom and quality-of-life status 1 year after therapy. Obstet Gynecol 106:1309–1318
Spies JB, Bruno J, Czeyda-Pommersheim F, et al. (2005) Long-term outcome of uterine artery embolization of leiomyomata. Obstet Gynecol 106:933–939
Walker WJ, Barton-Smith P (2006) Long-term follow up of uterine artery embolisation: An effective alternative in the treatment of fibroids. Br J Obstet Gynaecol 113:464–468
Katsumori T, Kasahara T, Akazawa K (2006) Long-term outcomes of uterine artery embolization using gelatin sponge particles alone for symptomatic fibroids. AJR Am J Roentgenol 186:848–854
Burn PR, McCall JM, Chinn RJ, et al. (2000) Uterine fibroleiomyoma: MR imaging appearances before and after embolization of uterine arteries. Radiology 214:729–734
Jha RC, Ascher SM, Imaoka I, et al. (2000) Symptomatic fibroleiomyomata: MR imaging of the uterus before and after uterine arterial embolization. Radiology 217:228–235
Pelage JP, Guaou NG, Jha RC, et al. (2004) Uterine fibroid tumors: Long-term MR imaging outcome after embolization. Radiology 230:803–809
Katsumori T, Nakajima K, Mihara T, et al. (2002) Uterine artery embolization using gelatin sponge particles alone for symptomatic uterine fibroids: Midterm results. AJR Am J Roentgenol 178:135–139
Kroencke TJ, Scheuring C, Schink T, et al. (2006) Devascularization of fibroids after UAE determines clinical outcome: A prospective study. J Vasc Interv Radiol 17:743
Fauconnier A, Chapron C, Babaki-Fard K, et al. (2000) Recurrence of leiomyomata after myomectomy. Hum Reprod Update 6:595–602
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Katsumori, T., Kasahara, T., Kin, Y. et al. Infarction of Uterine Fibroids After Embolization: Relationship Between Postprocedural Enhanced MRI Findings and Long-Term Clinical Outcomes. Cardiovasc Intervent Radiol 31, 66–72 (2008). https://doi.org/10.1007/s00270-007-9187-2
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DOI: https://doi.org/10.1007/s00270-007-9187-2