Unenhanced MR Angiography of Uterine and Ovarian Arteries after Uterine Artery Embolization: Differences between Patients with Incomplete and Complete Fibroid Infarction

• Published in: Cardiovascular and interventional radiology 2012-06, Vol.35 (3), p.515-522
• Main Authors: Mori, Kensaku, Saida, Tsukasa, Shibuya, Yoko, Takahashi, Nobuyuki, Shiigai, Masanari, Osada, Kayo, Tanaka, Nami, Minami, Manabu
• Format: Article
• Language: English
• Subjects: Adult; ANIMALS; ARTERIES; BIOMEDICAL RADIOGRAPHY; Blood Flow Velocity; BLOOD VESSELS; BODY; Cardiology; CARDIOVASCULAR SYSTEM; Clinical Investigation; Contrast Media; DIAGNOSTIC TECHNIQUES; ELEMENTS; Female; FEMALES; GADOLINIUM; Gadolinium DTPA; Humans; Image Interpretation, Computer-Assisted; Imaging; Imaging, Three-Dimensional; Leiomyoma - pathology; Leiomyoma - therapy; MAGNETIC RESONANCE; Magnetic Resonance Angiography - methods; MAMMALS; MAN; MEDICINE; Medicine & Public Health; METALS; Middle Aged; NUCLEAR MEDICINE; ORGANS; Ovary - blood supply; PATIENTS; PRIMATES; RADIOLOGY; RADIOLOGY AND NUCLEAR MEDICINE; RARE EARTHS; RESONANCE; Retrospective Studies; Statistics, Nonparametric; TIME-OF-FLIGHT METHOD; Ultrasound; Uterine Artery Embolization; Uterine Neoplasms - pathology; Uterine Neoplasms - therapy; Uterus - blood supply; VERTEBRATES; WOMEN
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-011-0182-2

Purpose To compare the status of uterine and ovarian arteries after uterine artery embolization (UAE) in patients with incomplete and complete fibroid infarction via unenhanced 3D time-of-flight magnetic resonance (MR) angiography. Materials and Methods Thirty-five consecutive women (mean age 43 years; range 26–52 years) with symptomatic uterine fibroids underwent UAE and MR imaging before and within 2 months after UAE. The patients were divided into incomplete and complete fibroid infarction groups on the basis of the postprocedural gadolinium-enhanced MR imaging findings. Two independent observers reviewed unenhanced MR angiography before and after UAE to determine bilateral uterine and ovarian arterial flow scores. The total arterial flow scores were calculated by summing the scores of the 4 arteries. All scores were compared with the Mann-Whitney test. Results Fourteen and 21 patients were assigned to the incomplete and complete fibroid infarction groups, respectively. The total arterial flow score in the incomplete fibroid infarction group was significantly greater than that in the complete fibroid infarction group ( P  = 0.019 and P  = 0.038 for observers 1 and 2, respectively). In 3 patients, additional therapy was recommended for insufficient fibroid infarction. In 1 of the 3 patients, bilateral ovarian arteries were invisible before UAE but seemed enlarged after UAE. Conclusion The total arterial flow from bilateral uterine and ovarian arteries in patients with incomplete fibroid infarction is less well reduced than in those with complete fibroid infarction. Postprocedural MR angiography provides useful information to estimate the cause of insufficient fibroid infarction in individual cases.