Uterine fibroleiomyoma: MR imaging appearances before and after embolization of uterine arteries.
OBJECTIVE
To evaluate the magnetic resonance (MR) imaging appearances of uterine fibroleiomyoma before and after embolization and to determine whether there are preembolization MR imaging characteristics that are predictive of a successful outcome.


METHODS
MR imaging was performed in 18 patients (32 fibroleiomyomas) before and at 2 and 6 months after embolization of the uterine arteries. On each occasion, fibroleiomyoma signal intensity and gadolinium enhancement characteristics were assessed in comparison with those of myometrium on T1-weighted and gadolinium-enhanced images or with those of skeletal muscle on T2-weighted images. Fibroleiomyoma volume was measured by using the ellipsoid formula.


RESULTS
The mean fibroleiomyoma volume before embolization was 340 cm3 (range, 15-1,383 cm3). The mean reduction in fibroleiomyoma volume was 43% at 2 months and 59% at 6 months. Before embolization, high signal intensity on T1-weighted images was predictive of a poor response (P = .008), and high signal intensity on T2-weighted images was predictive of a good response (P = .007). The degree of gadolinium enhancement was not correlated with fibroleiomyoma volume reduction (P = .46).


CONCLUSIONS
MR imaging was useful for evaluation of changes in fibroleiomyoma volume after uterine arterial embolization. MR imaging characteristics of fibroleiomyomas before embolization can help predict subsequent response to treatment.
Burn
P R
PR
Department of Radiology, Chelsea and Westminster Hospital, London, England. paulburn@lesbaux.demon.co.uk
McCall
J M
JM
Chinn
R J
RJ
Vashisht
A
A
Smith
J R
JR
Healy
J C
JC
D000328:Adult; D000792:Angiography; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D007889:Leiomyoma / Q000098:blood supply / Q000175:diagnosis* / Q000628:therapy; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000628:therapy