The effect of pelvic MR imaging on the diagnosis and treatment of women with presumed symptomatic uterine fibroids.
OBJECTIVE
To determine if magnetic resonance (MR) imaging significantly alters the diagnostic thinking and treatment plans of interventional radiologists during the evaluation of women for uterine fibroid embolization (UFE) for presumed uterine fibroids.


METHODS
At a single institution, interventional radiologists prospectively completed questionnaires (n = 60) before and after MR imaging was performed in their evaluation of women presenting for potential UFE. The questionnaires asked these physicians the probability (0%-100%) of their most likely diagnosis before MR imaging and after receiving the MR imaging information. They were also asked their anticipated and final treatment plans. Diagnostic confidence gains and the proportion of patients with changed initial diagnoses or anticipated management were calculated. The Wilcoxon signed-rank test was used to assess gains in diagnostic confidence.


RESULTS
MR imaging caused a mean gain in diagnostic confidence of 22% (P <.0001). MR imaging changed initial diagnoses in 11 patients (18%). Immediate clinical management changed in 13 patients (22%). UFE was not performed in 11 of 57 women (19%) who were anticipated before MR imaging to receive UFE.


CONCLUSIONS
MR imaging significantly alters the diagnoses and treatment plans of interventional radiologists evaluating women with presumed symptomatic fibroids. MR imaging should be considered in all patients before UFE.
Omary
Reed A
RA
Department of Radiology, Northwestern University Medical School, 676 North St. Clair, Suite 800, Chicago, Illinois 60611, USA. romary@radiology.northwestern.edu
Vasireddy
Syam
S
Chrisman
Howard B
HB
Ryu
Robert K
RK
Pereles
F Scott
FS
Carr
James C
JC
Resnick
Scott A
SA
Nemcek
Albert A
AA
Vogelzang
Robert L
RL
D000328:Adult; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000473:pathology* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010388:Pelvis / Q000473:pathology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014594:Uterine Neoplasms / Q000473:pathology* / Q000628:therapy*