Magnetic resonance imaging outcome after uterine artery embolization for leiomyomata with use of tris-acryl gelatin microspheres.
OBJECTIVE
To determine the imaging outcome after uterine artery embolization (UAE) with use of tris-acryl gelatin microspheres (Embospheres).


METHODS
A retrospective analysis of magnetic resonance (MR) images was performed comparing studies completed 3-4 months after UAE to those performed before UAE. Twenty-three patients with 61 leiomyomata (as many as three fibroids per patient) were examined. Orthogonal T2, axial T1-weighted fat-saturated, sagittal T2 fast spin-echo, and dynamic T1-weighted sagittal images after Gadolinium injection were analyzed. Two abdominal imaging specialists examined the volume and uterine and leiomyoma perfusion. The Wilcoxon signed-rank test was used for inferences in leiomyoma size difference, infarction, and volume of fibroid tissue perfused.


RESULTS
Median volume of all leiomyomata (n = 61) decreased by 52% (P <.001). For dominant fibroids alone (n = 23), a median 52% volume decrease (P <.001) was also noted, whereas the median uterine volume decreased 32%. Median perfused volume of all fibroids decreased from 31 mL to 0 mL, signifying a 100% decrease (P <.001). For dominant fibroids, a 100% median perfused volume decrease from 116 mL to 0 mL was noted (P <.001). Fifty-two of 61 fibroids (85%) and 20 of 23 dominant fibroids (87%) were completely devascularized and two fibroids disappeared. There was no myometrial ischemia identified.


CONCLUSIONS
Tris-acryl gelatin microspheres (Embospheres) are an effective embolic agent for UAE, causing infarction and significant decrease in leiomyoma volume.
Department of Radiology, Georgetown University, 3800 Reservoir Road NW, Washington, DC 20007, USA. banovac@isis.imac.georgetown.edu
Filip
F
Banovac
Susan M
SM
Ascher
Douglas A
DA
Jones
Marlon D
MD
Black
James C
JC
Smith
James B
JB
Spies
D000328:Adult; D001158:Arteries; D004621:Embolization, Therapeutic; D005260:Female; D005780:Gelatin; D006801:Humans; D007889:Leiomyoma / Q000473:pathology* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008863:Microspheres; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology* / Q000628:therapy*
D005780:Gelatin