J Korean Soc Radiol.  2010 May;62(5):477-481. 10.3348/jksr.2010.62.5.477.

Practical Application of a Coronal MR Image during a Uterine Fibroid Embolization (UFE)

• Jung JY
• Kim MD
• Lee HS
• Lee MH
• Kim HJ
• Cho JH
• Cha SH

• KMID: 2002957
• DOI: http://doi.org/10.3348/jksr.2010.62.5.477

Abstract

PURPOSE
To assess the role of coronal MR images during uterine fibroid embolization (UFE).
MATERIALS AND METHODS
A prospective study of 100 consecutive patients who underwent a uterine fibroid embolization was performed. The average age at embolization was 40.2 years (range, 19-49 years). The size of the predominant fibroids ranged from 2.5 cm to 21.0 cm (mean, 7.5 cm). The embolic agents included non-spherical polyvinyl alcohol particles. The angiographic and spot images after embolization were compared with coronal MR images. The patterns were divided into three categories: Matching, Undetermined, and Mismatching.
RESULTS
Coronal MR images were correlated with angiographic or single shot images of the uterus after embolization in 94 cases, undeterminined in three cases, and mismatched in three cases. Post-embolization aortographies were not helpful in patients showing complete matching images. In three cases of mismatching, two had ovarian collateral supplies to predominant fibroids in the uterine fundus and the remaining patient had an internal pudendal artery of collaterals to fibroid. Mismatching spot images combined with MRI allowed us to find other collateral vascularities.
CONCLUSION
Coronal MR images provided comprehensive information for the appropriate UFE. When perfectly matched, we could make sure that a particular UFE is appropriate without concern for collaterals.

MeSH Terms

Aortography
Arteries
Equipment and Supplies
Humans
Leiomyoma
Magnetic Resonance Imaging
Polyvinyl Alcohol
Prospective Studies
Uterine Artery Embolization
Uterine Neoplasms
Uterus
Polyvinyl Alcohol

Figure

• 

  Fig. 1 A 36-year-old woman with uterine leiomyoma. A. T2 weighted coronal MR image shows intramural myoma with a maximum diameter of 6 cm (arrows). B. Single shot image after embolization reveals perfect matching with a coronal MR image (arrows). C. Gadolinium-enhanced T1-weighted MR images at a 3-month follow-up examination after a UFE revealed volume reduction of the fibroid and no contrast enhancement, suggesting complete necrosis of the uterine leiomyoma.

• 

  Fig. 2 A 43-year-old woman with uterine leiomyoma. A. T2-weighted coronal images demonstrates subserosal myoma with a maximum diameter of 7 cm (arrows) located in the uterine fundus submucosal myoma B. Single shot image after embolization reveals mismatching with the coronal MR image. Hence, the subserosal myoma was not visualized, which resulted in a search for ovarian collaterals. C, D. Selective ovarian angiography shows staining of leiomyoma perfectly matching with the coronal MR image (arrows).

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