Assessment of the uterine artery before uterine arterial embolization: comparison of unenhanced 3D water-excitation sensitivity-encoding time-of-flight (WEST) and gadolinium-enhanced 3D sensitivity-encoding water-excitation multishot echo-planar (SWEEP) MR angiography.
OBJECTIVE
To compare unenhanced 3D water-excitation sensitivity-encoding time-of-flight (WEST) and gadolinium-enhanced 3D sensitivity-encoding water-excitation multishot echo-planar (SWEEP) MR angiography (MRA) with regard to conspicuity of uterine arteries in correlation with digital subtraction angiography (DSA).


METHODS
Eleven consecutive patients with symptomatic uterine fibroids underwent 2 types of MRA before uterine arterial embolization (UAE). From these MRA an interventional radiologist predicted the optimal degrees for oblique DSA projections to reveal uterine arterial origins. Qualitatively, three independent observers reviewed two types of MRA assessing the conspicuity of uterine arterial origins and descending portions using a 3-point scale. Quantitatively, the visualized uterine arteries were measured from their orifice to the end of their descending portions.


RESULTS
At UAE, knowing the optimal degrees from MRA, the uterine arterial origins were clearly visualized on all first oblique DSA projections. Mean conspicuity levels of the uterine arterial origins and descending portions were significantly higher and mean length of the visualized uterine arteries was significantly longer for unenhanced WEST MRA than for gadolinium-enhanced SWEEP MRA.


CONCLUSIONS
Unenhanced 3D-WEST MRA was superior to gadolinium-enhanced 3D-SWEEP MRA in demonstrating uterine arteries. The optimal degrees for DSA projections to reveal uterine arterial origins could be accurately predicted using this noninvasive technique.
Mori
Kensaku
K
Department of Diagnostic and Interventional Radiology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. moriken@md.tsukuba.ac.jp
Shiigai
Masanari
M
Ueda
Takuya
T
Kita
Naoki
N
Tanaka
Nami
N
Minami
Manabu
M
D000328:Adult; D015901:Angiography, Digital Subtraction; D001158:Arteries / Q000033:anatomy & histology; D003287:Contrast Media; D017352:Echo-Planar Imaging / Q000379:methods*; D004621:Embolization, Therapeutic; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional; D007889:Leiomyoma / Q000175:diagnosis; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008875:Middle Aged; D014594:Uterine Neoplasms / Q000175:diagnosis; D014599:Uterus / Q000098:blood supply*; D014867:Water
D003287:Contrast Media; D014867:Water; D005682:Gadolinium