title: Primary failure of uterine artery embolization: use of magnetic resonance imaging to select patients for repeated embolization.
abstract: The purpose of this study was to determine if contrast material-enhanced magnetic resonance (MR) imaging could be used to stratify patients who have undergone failed primary uterine artery embolization (UAE) for repeated embolization. One hundred one consecutive patients who underwent UAE at a single center were followed prospectively and assessed for the presence of persistent contrast enhancement of leiomyomas on follow-up MR imaging. Among 11 of the 111 patients with primary clinical failure (10%), MR imaging showed persistent enhancement in eight. Of the eight cases of failure with continued tumor enhancement on MR imaging, six were treated with repeated embolization. All six patients showed complete symptomatic relief at 12-month follow-up. In women who have been treated with failed primary UAE, continued enhancement of leiomyomas on MR imaging can be used to identify candidates for successful repeated UAE.
authors.affiliation: Department of Radiology, Northwestern University Medical School, 251 East Huron Street, Chicago, IL 60093, USA. hchrisman@northwestern.edu
authors.forename: Howard B
authors.initials: HB
authors.lastname: Chrisman
authors.forename: Derek
authors.initials: D
authors.lastname: West
authors.forename: Ben
authors.initials: B
authors.lastname: Corpuz
authors.forename: Robert K
authors.initials: RK
authors.lastname: Ryu
authors.forename: Riad
authors.initials: R
authors.lastname: Salem
authors.forename: James
authors.initials: J
authors.lastname: Carr
authors.forename: Robert
authors.initials: R
authors.lastname: Vogelzang
authors.forename: Reed A
authors.initials: RA
authors.lastname: Omary
mesh_terms: D001158:Arteries; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007889:Leiomyoma / Q000098:blood supply* / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D019233:Retreatment; D017211:Treatment Failure; D014594:Uterine Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000628:therapy*; D014599:Uterus / Q000098:blood supply
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA