Uterine fibroids: contrast-enhanced MR angiography to predict ovarian artery supply--initial experience.
OBJECTIVE
To prospectively evaluate the diagnostic performance of contrast material-enhanced magnetic resonance (MR) angiography in helping predict ovarian artery supply of uterine fibroids by using postembolization conventional aortography as the reference standard.


METHODS
The protocol for the study was approved by the institutional review board, and each patient gave informed consent. Ninety consecutive women (mean age, 42.5 years; range, 33-63 years) underwent MR angiography before uterine artery embolization (UAE). The number and origin of the ovarian arteries were determined. Ovarian artery supply of fibroids was graded as very unlikely, possible, or very likely by using a scoring system based on a combination of MR angiographic findings. MR angiographic results were compared with those of conventional aortography performed after UAE in all patients and followed by selective angiography in case of a suspected ovarian artery supply of fibroids. Analysis of the association between MR angiographic grading and conventional angiography as the standard of reference was performed with a chi(2) trend test. Sensitivity and specificity, including exact 95% confidence intervals (CIs), of MR angiography were determined.


RESULTS
MR angiography depicted 18 ovarian arteries (four bilateral, 10 unilateral), one with an atypical origin. Five ovarian arteries were classified as very likely; three, as possible; and 10, as very unlikely sources of arterial fibroid supply. Seven (39%) of 18 ovarian arteries detected at MR angiography were visible at conventional aortography. Fibroid supply was verified at selective angiography in five ovarian arteries in five (6%) of 90 patients. There was a strong association between MR angiographic grading and the results of conventional angiography (P = .002). Sensitivity of MR angiography in depicting ovarian artery supply (grade, possible or very likely) was 100% (five of five, 95% CI: 48%; 100%) and specificity was 77% (10 of 13, 95% CI: 46%; 95%).


CONCLUSIONS
Contrast-enhanced MR angiography can help predict ovarian artery supply of uterine fibroids.
Kroencke
Thomas J
TJ
Department of Radiology, Charité Universitätsmedizin Berlin, Campus Mitte, Schumannstrasse 20/21, 10117 Berlin, Germany. thomas.kroencke@charite.de
Scheurig
Christian
C
Kluner
Claudia
C
Taupitz
Matthias
M
Schnorr
Jörg
J
Hamm
Bernd
B
D000328:Adult; D001027:Aortography; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007889:Leiomyoma / Q000098:blood supply* / Q000628:therapy; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008875:Middle Aged; D010053:Ovary / Q000098:blood supply*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014594:Uterine Neoplasms / Q000098:blood supply* / Q000628:therapy
D003287:Contrast Media