title: Contribution of contrast-enhanced ultrasound with Sonovue to describe the microvascularization of uterine fibroid tumors before and after uterine artery embolization.
abstract: OBJECTIVE
  The principal objective of this study was to use contrast-enhanced ultrasonography to describe the characteristics of fibroid microvascularization before and after embolization.
  
  
  METHODS
  Forty women had contrast-enhanced ultrasonography with Sonovue(®) injections before uterine artery embolization, the day afterwards, and at 6-12 months afterwards. An MRI was also performed before and after the procedure.
  
  
  RESULTS
  Two thirds of the fibroids took up the contrast product before the myometrium did, and 45.8% were vascularized along the peripheral rim of the fibroid, compared with 41.6% with a principal pedicle and from the center in three (12.6%). After embolization at day one (D1), the myometrium was fully enhanced, that is, perfusion of the myometrium was plainly visible, in 25 cases (69.4%; n=36), partially enhanced in eight (22.2%), and totally avascular in three (8.4%). Analysis of the failures according to imaging criteria the day after embolization (D1) showed failure in seven women, with partial enhancement for six, and total for one. In the imaging at 6 months (M6), contrast ultrasonography showed failure for three women, with enhancement of the largest fibroid. This enhancement was total in two cases and partial (40%) in one. There were five failures according to MRI at M6, with partial enhancement. Only two of these failures were simultaneously failures according to the contrast-enhanced ultrasonography. There were five clinical failures, two consistent with the imaging at 6 months and four predictable on D1.
  
  
  CONCLUSIONS
  Contrast-enhanced ultrasonography is feasible and useful to understand fibroid vascularization and for monitoring embolization; its correlation with MRI is good, its concordance less so.
authors.affiliation: Pole de Gynécologie, Obstétrique, Médecine foetale et Reproduction humaine, France; Service de neuroradiologie interventionnelle, CHU Bretonneau 37044 Tours cedex 1 France; Groupement d'imagerie médicale, Unité Médicale Ultrasons. CHU Bretonneau 37044 Tours cedex 1 France; Bracco Research SA, 31, Route de la Galaise, Plan les Ouates, Switzerland. Electronic address: marret@med.univ-tours.fr.
authors.forename: Marret
authors.initials: M
authors.lastname: Henri
authors.affiliation: Pole de Gynécologie, Obstétrique, Médecine foetale et Reproduction humaine, France; Service de neuroradiologie interventionnelle, CHU Bretonneau 37044 Tours cedex 1 France; Groupement d'imagerie médicale, Unité Médicale Ultrasons. CHU Bretonneau 37044 Tours cedex 1 France; Bracco Research SA, 31, Route de la Galaise, Plan les Ouates, Switzerland.
authors.forename: Eboué
authors.initials: E
authors.lastname: Florence
authors.affiliation: Groupement d'imagerie médicale, Unité Médicale Ultrasons. CHU Bretonneau 37044 Tours cedex 1 France.
authors.forename: Bleuzen
authors.initials: B
authors.lastname: Aurore
authors.affiliation: Service de neuroradiologie interventionnelle, CHU Bretonneau 37044 Tours cedex 1 France.
authors.forename: Herbreteau
authors.initials: H
authors.lastname: Denis
authors.affiliation: Groupement d'imagerie médicale, Unité Médicale Ultrasons. CHU Bretonneau 37044 Tours cedex 1 France.
authors.forename: Patat
authors.initials: P
authors.lastname: Frederic
authors.affiliation: Bracco Research SA, 31, Route de la Galaise, Plan les Ouates, Switzerland.
authors.forename: Tranquart
authors.initials: T
authors.lastname: Francois
authors.affiliation: Pole de Gynécologie, Obstétrique, Médecine foetale et Reproduction humaine, France; Service de neuroradiologie interventionnelle, CHU Bretonneau 37044 Tours cedex 1 France; Groupement d'imagerie médicale, Unité Médicale Ultrasons. CHU Bretonneau 37044 Tours cedex 1 France; Bracco Research SA, 31, Route de la Galaise, Plan les Ouates, Switzerland.
authors.forename: Ouldamer
authors.initials: O
authors.lastname: Lobna
mesh_terms: D000328:Adult; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007889:Leiomyoma / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000628:therapy; D008279:Magnetic Resonance Imaging; D055806:Microvessels / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009215:Myometrium / Q000098:blood supply / Q000000981:diagnostic imaging; D010743:Phospholipids; D011446:Prospective Studies; D013459:Sulfur Hexafluoride; D013997:Time Factors; D017211:Treatment Failure; D018608:Ultrasonography, Doppler; D055357:Uterine Artery Embolization; D014594:Uterine Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000628:therapy
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: Contrast ultrasound; Fibroids; MRI.; Myoma; Sonovue; Uterine artery embolization