title: Pain after uterine fibroid embolisation is associated with the severity of myometrial ischaemia on magnetic resonance imaging.
abstract: The purpose of the study was to evaluate uterine ischaemia after uterine artery embolisation (UAE) using magnetic resonance imaging and the role of myometrial and fibroid ischaemia in the pathogenesis of post-procedural pain. T1-weighted gradient echo imaging before and after contrast agent was performed on 62 women before and 24 h after UAE. We assessed the severity (mild, moderate, severe) of myometrial ischaemia, and the percentage and volume of ischaemic tissue in myometrium and fibroids. The Verbal Rating Scale was used to assess in-hospital post-procedural pain (1-3 mild, 4-6 moderate, 7-10 severe). Mean maximal pain was 7.7. Myometrial ischaemia was mild, moderate and severe in 29, 23 and 10 patients, respectively. Moderate or severe myometrial ischaemia (p = 0.041), the percentage (p = 0.037) and volume (p = 0.012) of ischaemic tissue in the myometrium, and a large volume of embolic material (p = 0.038) correlated with severe pain. In summary, pain following UAE is common and partly explained by myometrial ischaemia.
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Finland. anu.ruuskanen@kuh.fi
authors.forename: Anu
authors.initials: A
authors.lastname: Ruuskanen
authors.forename: Petri
authors.initials: P
authors.lastname: Sipola
authors.forename: Maritta
authors.initials: M
authors.lastname: Hippeläinen
authors.forename: Marion
authors.initials: M
authors.lastname: Wüstefeld
authors.forename: Hannu
authors.initials: H
authors.lastname: Manninen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology*; D007889:Leiomyoma / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009215:Myometrium / Q000098:blood supply*; D010146:Pain / Q000175:diagnosis / Q000209:etiology*; D055357:Uterine Artery Embolization / Q000009:adverse effects*