title: Uterine artery embolization (UAE) for diffuse leiomyomatosis of the uterus: clinical and imaging results.
abstract: OBJECTIVE
  The aim of the current study was to evaluate the efficacy of uterine artery embolization (UAE) in the management of diffuse uterine leiomyomatosis with mid-term follow-up.
  
  
  METHODS
  All patients who underwent UAE between 2008 and 2010 for symptomatic fibroids were analyzed. Among 360 cases, a total of 7 patients with diffuse uterine leiomyomatosis diagnosed based on MRI were included in this retrospective study. Patient ages ranged from 29 to 38 (mean 32.7) years. The median follow-up period was 16 (range; 6-31) months. The embolic agent was non-spherical polyvinyl alcohol particles. All patients underwent follow-up MRI at 3 months after UAE. Uterine volumes were calculated using MRI. Menorrhagia symptom changes were assessed at mid-term follow-up.
  
  
  RESULTS
  There were no technical failures to catheterize the uterine artery and no adverse events requiring therapy after UAE. Contrast-enhanced MRI showed complete necrosis of the leiomyomatous nodules in 5 patients (71%) 3 months after embolization. Two patients (28%) showed mostly leiomyomatous nodules that were necrotized, some of which were still viable. All 7 patients with menorrhagia had improvement of symptoms at the mid-term follow-up. The initial mean uterine volume was 601.30 ± 533.92 cm(3) and was decreased to a mean of 278.81 ± 202.70 cm(3) at 3 months follow-up, for a mean uterus volume reduction rate of 50.1% (p<0.05). One patient became pregnant 5 months after UAE treatment.
  
  
  CONCLUSIONS
  UAE was a highly effective treatment for diffuse uterine leiomyomatosis with mid-term durability and may be a valuable alternative to hysterectomy.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Shinchon-dong, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Jieun
authors.initials: J
authors.lastname: Koh
authors.forename: Man Deuk
authors.initials: MD
authors.lastname: Kim
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Jung
authors.forename: Myungsu
authors.initials: M
authors.lastname: Lee
authors.forename: Mu Sook
authors.initials: MS
authors.lastname: Lee
authors.forename: Jong Yun
authors.initials: JY
authors.lastname: Won
authors.forename: Do Yun
authors.initials: DY
authors.lastname: Lee
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Park
authors.forename: Kwang Hun
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D018231:Leiomyomatosis / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000706:statistics & numerical data*; D014594:Uterine Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*