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Diffusion-weighted MR imaging of uterine leiomyomas following uterine artery embolization

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Abstract

Purpose

To test whether variations in apparent diffusion coefficient (ADC) values of uterine leiomyomas after uterine artery embolization (UAE) may correlate with outcome and assess the effects of UAE on leiomyomas and normal myometrium with magnetic resonance imaging (MRI).

Methods

Data of 49 women who underwent pelvic MRI before and after UAE were retrospectively reviewed. Uterine and leiomyoma volumes, ADC values of leiomyomas, and normal myometrium were calculated before and after UAE.

Results

By comparison with baseline ADC values, a significant drop in leiomyoma ADC was found at 6-month post-UAE (1.096 × 10-3 mm2/s vs. 0.712 × 10-3 mm2/s, respectively; p < 0.0001), but not at 48-h post-UAE. Leiomyoma devascularization was complete in 40/49 women (82 %) at 48 h and in 37/49 women (76 %) at 6 months. Volume reduction and leiomyoma ADC values at 6 months correlated with the degree of devascularization. There was a significant drop in myometrium ADC after UAE. Perfusion defect of the myometrium was observed at 48 h in 14/49 women (28.5 %) in association with higher degrees of leiomyoma devascularization.

Conclusion

Six months after UAE, drop in leiomyoma ADC values and volume reduction correlate with the degree of leiomyoma devascularization. UAE affects the myometrium as evidenced by a drop in ADC values and initial myometrial perfusion defect.

Key Points

• A drop in leiomyoma ADC values is observed 6 months after UAE.

• Drop in leiomyoma ADC value is associated with leiomyoma devascularizarion after UAE.

• MR 48 h post-UAE allows assessing leiomyoma devascularization.

• Myometrium perfusion defect occurs more often in women with a smaller uterus.

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Acknowledgments

The scientific guarantor of this publication is Anthony Dohan, MD. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Body and Interventional Imaging, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France

    Olivier Sutter, Philippe Soyer, Eimad Shotar, Raphael Dautry, Youcef Guerrache, Vinciane Placé, Raluca Opréa, Olivier Le Dref, Mourad Boudiaf, Marc Sirol & Anthony Dohan

  2. Université Paris-Diderot, Sorbonne Paris Cité, 10 rue de Verdun, 75010, Paris, France

    Philippe Soyer, Raphael Dautry, Marc Sirol & Anthony Dohan

  3. UMR INSERM 965, Hôpital Lariboisière, 2 rue Amboise Paré, 75010, Paris, France

    Philippe Soyer & Anthony Dohan

  4. Department of Obstetrics and Gynecology, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France

    Aude Ricbourg

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  1. Olivier Sutter
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Correspondence to Anthony Dohan.

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Sutter, O., Soyer, P., Shotar, E. et al. Diffusion-weighted MR imaging of uterine leiomyomas following uterine artery embolization. Eur Radiol 26, 3558–3570 (2016). https://doi.org/10.1007/s00330-016-4210-0

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  • DOI: https://doi.org/10.1007/s00330-016-4210-0

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