Long-term results of symptomatic fibroids treated with uterine artery embolization: in conjunction with MR evaluation.
OBJECTIVE
The aim of the present study is to determine long-term clinical efficacy of uterine fibroid embolization (UFE) for symptomatic fibroids in conjunction with MR evaluation.


METHODS
Sixteen patients with a follow-up period of 4 years or longer were analyzed retrospectively. Ages ranged from 27 to 45 (mean 39.5) years. Mean follow-up periods were 5.8 years (range: 4.1-6.9 years). The symptom changes, in terms of menorrhagia and dysmenorrhea and bulk-related symptoms, were assessed. The primary embolic agent was polyvinyl alcohol particle (250-710microm). All patients underwent preprocedural and long-term follow up MR imaging. Uterine volumes were calculated using MRI.


RESULTS
Symptom improvements were reported for menorrhagia (8/9, 88.9%), dysmenorrhea (5/5, 100%), and bulk-related symptoms (7/9, 77.8%) at long-term follow up. Two patients (12.5%) had symptom recurrences at long-term follow-up. Tumor regrowth from incomplete infarction was a cause of recurrence in one patient and newly developed leiomyomas in the other one. One patient underwent hysterectomy because endometriosis developed 4 years after UFE. Of the 14 necrotic myomas on short-term follow up MR after UFE, eight (57.1%) demonstrated maintaining necrosis with further shrinkage and six (42.9%) were no longer visualized on long-term follow up MR images. Overall, the mean volume reduction rates of the predominant fibroid and uterus were 80.5%, 36.7% at long-term follow up, respectively.


CONCLUSIONS
UFE is an effective treatment for symptomatic fibroids with an acceptable long-term success rate. Long-term MR imaging after UFE revealed persistent necrotic fibroid, non-visualization of fibroids and tumor regrowth when incompletely infarcted.
Kim
Man Deuk
MD
Department of Diagnostic Radiology Bundang CHA General Hospital, Pochon CHA University, Republic of Korea. mdkim@cha.ac.kr
Lee
Hyun Seok
HS
Lee
Mee Hwa
MH
Kim
Hee Jin
HJ
Cho
Jin Ho
JH
Cha
Sun Hee
SH
D000328:Adult; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis* / Q000628:therapy*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000379:methods*; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000628:therapy*