[Transarterial embolization for uterine fibroids: clinical success rate and results of magnetic resonance imaging].
OBJECTIVE
To analyze the clinical success rate and the findings of magnetic resonance imaging (MRI) after uterine artery embolization of symptomatic leiomyomas (fibroids) of the uterus.


METHODS
This is a prospective single-center case study of 80 consecutively treated patients, followed for 3 - 6 months (group I), 7 - 12 months, (group II), and 13 - 25 months (group III). MRI was used to determine the uterine volume and size of the dominant leiomyoma. Symptoms and causes requiring repeat interventions were analyzed.


RESULTS
Significant (p < 0.01) volume reduction of the uterus (median: 34.95 % confidence interval [CI]: 30.41 - 41.76 %) and dominant leiomyoma (median: 52.07 %, CI: 47.71 - 61.57 %) was found. The decrease in uterine volume (I-III: 22.68 %, 33.56 %, 47.93 %) and dominant leiomyoma volume (I-III: 41.86 %, 62.16 %, 73.96 %) progressed with the follow-up time. Bleeding resolved significantly (p < 0.0001) in all three follow-up groups (groups I-III: 92.86 %, 95.23 %, 96.67 %). Furthermore, urinary frequency (groups I-III: 70 %, 75 %, 82.35 %) and sensation of pelvic pressure (groups I-III: 42.86 %, 60 %, 93.75 %) improved, which was statistically significant in group III (p < 0.01). The number of leiomyomas correlated (p < 0.05) with improvement of the bleeding and the pelvic pressure. Repeat therapy was necessary for complications in four patients (5 %) and for therapeutic failure in three patients (3.8 %). Permanent amenorrhea was observed in four patients (5 %) of age 45 years or older.


CONCLUSIONS
Uterine artery embolization of uterine leiomyomas has a high clinical success rate with an acceptable incidence of complications and repeat interventions.
Kröncke
T J
TJ
Institut für Radiologie, Charité Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin. thomas.kroencke@charite.de
Gauruder-Burmester
A
A
Scheurig
C
C
Gronewold
M
M
Klüner
C
C
Fischer
T
T
Klessen
C
C
Rudolph
J
J
Siara
K
K
Zimmermann
E
E
Hamm
B
B
D000328:Adult; D001158:Arteries; D003627:Data Interpretation, Statistical; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D015642:Radiology, Interventional; D013997:Time Factors; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000628:therapy*; D014599:Uterus / Q000098:blood supply