Uterine artery embolization (UAE) for diffuse leiomyomatosis of the uterus: clinical and imaging results.

Abstract

PURPOSE:

The aim of the current study was to evaluate the efficacy of uterine artery embolization (UAE) in the management of diffuse uterine leiomyomatosis with mid-term follow-up.

MATERIALS AND METHODS:

All patients who underwent UAE between 2008 and 2010 for symptomatic fibroids were analyzed. Among 360 cases, a total of 7 patients with diffuse uterine leiomyomatosis diagnosed based on MRI were included in this retrospective study. Patient ages ranged from 29 to 38 (mean 32.7) years. The median follow-up period was 16 (range; 6-31) months. The embolic agent was non-spherical polyvinyl alcohol particles. All patients underwent follow-up MRI at 3 months after UAE. Uterine volumes were calculated using MRI. Menorrhagia symptom changes were assessed at mid-term follow-up.

RESULTS:

There were no technical failures to catheterize the uterine artery and no adverse events requiring therapy after UAE. Contrast-enhanced MRI showed complete necrosis of the leiomyomatous nodules in 5 patients (71%) 3 months after embolization. Two patients (28%) showed mostly leiomyomatous nodules that were necrotized, some of which were still viable. All 7 patients with menorrhagia had improvement of symptoms at the mid-term follow-up. The initial mean uterine volume was 601.30 ± 533.92 cm(3) and was decreased to a mean of 278.81 ± 202.70 cm(3) at 3 months follow-up, for a mean uterus volume reduction rate of 50.1% (p<0.05). One patient became pregnant 5 months after UAE treatment.

CONCLUSION:

UAE was a highly effective treatment for diffuse uterine leiomyomatosis with mid-term durability and may be a valuable alternative to hysterectomy.

• Authors: Jieun Koh, Man Deuk Kim, Dae Chul Jung, Myungsu Lee, Mu Sook Lee, Jong Yun Won, Do Yun Lee, Sung Il Park, Kwang Hun Lee
• Journal: European journal of radiology (Eur J Radiol) Vol. 81 Issue 10 Pg. 2726-9 (Oct 2012) ISSN: 1872-7727 [Electronic] Ireland
• PMID: 22154588 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Topics

• Adult
• Female
• Humans
• Leiomyomatosis (epidemiology, pathology, therapy)
• Magnetic Resonance Imaging (statistics & numerical data)
• Prevalence
• Prognosis
• Republic of Korea (epidemiology)
• Treatment Outcome
• Uterine Artery Embolization (statistics & numerical data)
• Uterine Neoplasms (epidemiology, pathology, therapy)