CONTRAST ENHANCED MRI IN LEIOMYOMA UTERI PRIOR UTERINE ARTERY EMBOLIZATION ASSESSEMENT
https://doi.org/10.18705/2311-4495-2016-3-5-64-74
Abstract
Uterine artery embolization (UAE) is minimally invasive, less complicated and uterine-preserve procedure when compared to traditional surgical options. Magnetic resonance (MR) imaging is the preferred modality in gynecologic pathology visualization. MR imaging is more accurate than transvaginal ultrasound in evaluating number, size and structure of the fibroids as well as their vascularization (by means of contrast enhancement) on pre-UAE uterus. MRI was performed in 97 women (35-49 y.o.) with symptomatic leiomyoma. In 21 women accompanying pathology was found partially explaining their symptoms. T he exclusion criteria also included subserosal leiomyoma on the narrow stalk (in 3 women) and huge (more than 9 cm in diameter) leiomyomas (in 10 women). In one woman leiomyoma expulsion was registered. U AE was performed in 42 women of 62 that were recommended after MRI. In all women contrast enhanced MRI, was performed also in 1, 6 and 12 month after the procedure. Shrinkage of fibroids as well as the absence of their enhancement was registered, showing the success or the manipulation. T hus, enhanced MRI is essential in uterine artery embolization efficiency assessment, predicting treatment response and it’s complications.
About the Authors
E. A. Pavlovskaya
Federal Almazov North-West Medical Research Centre
Federal state budgetary military educational institution of higher education «Military Medical Academy named after S.M.Kirov» of the Ministry of defence of the Russian Federation
Russian Federation
Russian Federation
scientific researcher of SIL of radiological diagnostics aspirant
Akkuratova str. 2, Saint Petersburg, Russia, 197341
S. A. Sosin
Federal Almazov North-West Medical Research Centre
Russian Federation
Russian Federation
teaching assistant in Obstetrics and gynaecology department
E. A. Yukhno
Federal Almazov North-West Medical Research Centre
Federal state budgetary military educational institution of higher education «Military Medical Academy named after S.M.Kirov» of the Ministry of defence of the Russian Federation
Russian Federation
PhD, radiologist in MRI Department
Russian Federation
PhD, radiologist in MRI Department
O. A. Sergienya
Federal Almazov North-West Medical Research Centre
Russian Federation
aspirant
Russian Federation
aspirant
G. E. Trufanov
Federal Almazov North-West Medical Research Centre
Russian Federation
Russian Federation
MD, PhD, professor, head of research department of radiology
References
1. Zimmermann A, Bernuit D, Gerlinger C, Schaefers M, Geppert K. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Womens Health. 2012; 12:16.
2. Kido A, Ascher SM, Kishimoto K, Hahn W, Jha RC, T ogashi K, Spies JB. Comparison of uterine peristalsis before and after uterine artery embolization at 3-T MRI. AJR Am J Roentgenol. 2011; 196(6): 1431-1435.
3. Hillard PJA. Benign diseases of the female reproductive tract: symptoms and signs. In: Berek J, ed. Novak’s gynecology. 13th ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2002: 351–420.
4. Sidorova IS, U nanyan AL, Ageev MB et al. Current status of the pathogenesis, clinical features, diagnosis, and treatment of uterine fibromas in reproductive age women. Obstetrics, gynecology, reproduction. 2012; 6(4):22-28. In Russian [Сидорова И .С., А .Л. У нанян, А геев М.Б. и др. Современное состояние вопроса о патогенезе, клинике, диагностике и лечении миомы матки у женщин репродуктивного возраста. А кушерство, гинекология, репродукция. 2012; 6(4):22−28].
5. Vyhlyaeva EM. U terine fibroids diagnostics and treatment guideline. M.: MEDpress- inform, 2004. p. 400. In Russian [Вихляева Е. М. Р уководство по диагностике и лечению больных лейомиомой матки. М.: МЕДпрессинформ, 2004. с. 400].
6. Trufanov GE, Panov VO. Diagnostic imaging in gynecology guideline. SPb.: ELBI, 2008. p. 590. In Russian [Труфанов Г .Е., Панов В.О. Р уководство по лучевой диагностике в гинекологии. СПб.: ЭЛБИ, 2008. с. 590].
7. Tikhomirov AM, O leynik ChG, Lubnin DM. Uterine fibroids treatment tactics: for obstetricians and gynecologists. M.: Medical information agency, 2007. p.176. In Russian [Тихомиров А .М., О лейник Ч.Г., Лубнин Д .М. Т актика лечения больных миомой матки: методическое пособие для врачей акушеров-гинекологов. М.: Медицинское информационное агентство, 2007. с.176].
8. Bulman JC, Ascher SM, Spies JB. Current concepts in uterine fibroid embolization. Radiographics. 2012; 32:1735−1750.
9. Walker WJ, Pelage JP. U terine artery embolization for symptomatic fibroids: clinical results in 400 women with imaging follow-up. BJOG. 2002; 109: 1262-1272.
10. Spies JB et al. U terine artery embolization for leiomyomata. O bstet. Gynecol. 2001; 98(1): 29−34.
11. Moss J, Cooper K, Khaud A et al. Randomized comparison of uterine artery embolization (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-year results. BJOG. 2011; 118: 936–944.
12. Tomislav S, Josip M, Liana CS, Marko V, Marko J, Ante R, Dzenis J, Leo G, Ivica S, Marijan T , Situm K. Uterine artery embolization as nonsurgical treatment of uterine myomas. ISRN O bstet Gynecol. 2011; 2011:489281.
13. Hubert J et al. Imaging the female pelvis: when should MRI be considered. Appl. Radiol. 2008; 37(1): 9−24.
14. Siddiqui N, Nikolaidis P et al. U terine artery embolization: pre- and postprocedual evaluation using magnetic resonance imaging. Abdominal imaging. 2013; 38:1161−1177.
15. Spielmann AL, Keogh C et al. Comparison of MRI and sonography in the preliminary evaluation for fibroid embolization. AJR. 2006; 187:1499−1504.
16. Levens ED, Wesley R, Premkumar A, Blocker W, Nieman LK. Magnetic resonance imaging and transvaginal ultrasound for determining fibroid burden: implications for research and clinical care. Am J O bstet Gynecol. 2009; 200(5):537.e1-7.
17. Muraze E et al. U terine Leiomyomas: histopathologic features, MR imaging findings, differential diagnosis and treatment. RadioGraphics. 1999: 19:1179−1197.
18. Rein MS, Friedman AJ. Progesterone: critical role in the pathogenesis of uterine myomas. Am. J. O bstet. Gynecol. 1995; 172:14−18.
19. Ueda H, T ogashi K, Konishi I et al. U nusual appearances of uterine leiomyomas: MR imaging findings and their histopathologic backgrounds. RadiogGraphics. 1999; 19(11): 131−145.
Review
For citations:
Pavlovskaya E.A., Sosin S.A., Yukhno E.A., Sergienya O.A., Trufanov G.E. CONTRAST ENHANCED MRI IN LEIOMYOMA UTERI PRIOR UTERINE ARTERY EMBOLIZATION ASSESSEMENT. Translational Medicine. 2016;3(5):64-74. (In Russ.) https://doi.org/10.18705/2311-4495-2016-3-5-64-74
Views:
1107
Email this article 