Predictive factors for pelvic magnetic resonance in response to arterial embolization of a uterine leiomyoma

Authors

  • Eduardo Zlotnik Universidade de Universidade de Sao Paulo; Faculdade de Medicina; Gynecology Clinic; Hospital das Clinicas
  • Marcos de Lorenzo Messina Universidade de Universidade de Sao Paulo; Faculdade de Medicina; Gynecology Clinic; Hospital das Clinicas
  • Felipe Nasser Hospital Israelita Albert Einstein; Interventional Radiology Department
  • Breno Boueri Affonso Universidade de Universidade de Sao Paulo; Faculdade de Medicina; Gynecology Clinic; Hospital das Clinicas
  • Ronaldo Hueb Baroni Hospital Israelita Albert Einstein; Interventional Radiology Department
  • Nelson Wolosker Universidade de Universidade de Sao Paulo; Faculdade de Medicina; Gynecology Clinic; Hospital das Clinicas
  • Edmund Chada Baracat Universidade de Universidade de Sao Paulo; Faculdade de Medicina; Gynecology Clinic; Hospital das Clinicas

DOI:

https://doi.org/10.1590/clin.v69i3.77109

Abstract

OBJECTIVE: Minimally invasive methods are used as alternatives to treat leiomyomas and include uterine artery embolization, which has emerged as a safe, effective method. This study aims to evaluate the magnetic resonance imaging predictors for a reduction in leiomyoma volume in patients undergoing uterine artery embolization. METHODS: This prospective longitudinal study was performed at a university hospital. We followed 50 symptomatic premenopausal women with uterine leiomyomas who underwent uterine artery embolization. We examined 179 leiomyomas among these patients. Magnetic resonance imaging was performed one month before and six months after uterine artery embolization. Two radiologists who specialized in abdominal imaging independently interpreted the images. Main Outcome Measures: The magnetic resonance imaging parameters were the uterus and leiomyomas volumes, their localizations, contrast perfusion pattern and node-to-muscle ratio. RESULTS: Six months after treatment, the average uterine volume reduction was 38.91%, and the leiomyomas were reduced by 55.23%. When the leiomyomas were submucosal and/or had a higher node-to-muscle ratio in the T2 images, the volume reduction was even greater (greater than 50%). Other parameters showed no association. CONCLUSIONS: We conclude that symptomatic uterine leiomyomas in patients undergoing uterine artery embolization exhibit volume reductions greater than 50% by magnetic resonance imaging when the leiomyomas are submucosal and/or had a high node-to-muscle ratio in the T2 images.

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Published

2014-03-01

Issue

Section

Clinical Sciences

How to Cite

Zlotnik, E., de Lorenzo Messina, M., Nasser, F., Affonso, B. B., Baroni, R. H., Wolosker, N., & Baracat, E. C. (2014). Predictive factors for pelvic magnetic resonance in response to arterial embolization of a uterine leiomyoma. Clinics, 69(3), 185-189. https://doi.org/10.1590/clin.v69i3.77109