The role of Magnetic resonance imaging in evaluation of leiomyoma after uterine artery embolization

Abstract

Uterine fibroids are the most common benign tumours in women and accounts for the majority of hysterectomies in the world. Their effect range from heavy menstrual bleeding, pressure symptoms and pain up to infertility.Uterine Artery embolization (UAE) is now evolving to be the first-line treatment for symptomatic uterine leiomyoma alongside the conventional surgical treatment of hysterectomy and myomectomy. MR imaging performed be¬fore and after UAE is the best imaging modality to diagnose, map, and characterize fibroids, and it can detect their state of vascularity and degeneration, it also helps to assess pathologies that may pre¬clude UAE, or change the embolization protocol, such as the presence of adenomyosis. This study emphasized the important role of follow up MRI after UAE that was performed on 15 women. The mean uterine volume was significantly reduced by 61% (P value 0.015), the mean dominant fibroids volume was significantly reduced by 79% (P value 0.004) and the dominant fibroids showed significant lack of enhancement 100% (P value <0.001).