title: Uterine Artery Embolization for Adenomyosis: Percentage of Necrosis Predicts Midterm Clinical Recurrence.
abstract: To evaluate the effect of degree of necrosis after uterine artery embolization (UAE) on symptom recurrence at midterm clinical follow-up in patients with adenomyosis.
  
  
  
  Women (N = 50) who underwent UAE for symptomatic adenomyosis were retrospectively analyzed. All patients underwent contrast-enhanced magnetic resonance (MR) imaging at baseline and 3 months after UAE and were followed clinically for at least 18 months. The type of adenomyosis was classified as focal or diffuse. The uterine volume and the percentage of necrosis after embolization were measured three-dimensionally on MR imaging. The percentage of the necrosis cutoff point for predicting recurrence was estimated. Patients were divided into 2 groups according to the cutoff point. The rate of recurrence was compared between groups, and risk factors for recurrence were identified.
  
  
  
  During the follow-up period (range, 18-48 mo), symptom recurrence occurred in 12 of 50 patients. A necrosis cutoff point of 34.3% was calculated to predict recurrence (area under the curve = 0.721; 95% confidence interval [CI] = 0.577-0.839; P = .004). Patients with < 34.3% necrosis (group A, n = 12) were at a significantly higher risk of recurrence than patients with > 34.3% necrosis (group B, n = 38; hazard ratio = 7.0; 95% CI = 2.2, 22.4; P = .001). Initial uterine volume and type of adenomyosis were not associated with recurrence.
  
  
  
  The percentage of necrosis in patients with adenomyosis after UAE may predict symptom recurrence at midterm follow-up. The cutoff percentage of necrosis required to predict symptom recurrence was 34.3% in this study.
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Sohi H
authors.initials: SH
authors.lastname: Bae
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.. Electronic address: mdkim@yuhs.ac.
authors.forename: Man Deuk
authors.initials: MD
authors.lastname: Kim
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Gyoung Min
authors.initials: GM
authors.lastname: Kim
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Shin Jae
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Park
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Jong Yun
authors.initials: JY
authors.lastname: Won
authors.affiliation: Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Do Yun
authors.initials: DY
authors.lastname: Lee
mesh_terms: D062788:Adenomyosis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D000328:Adult; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008595:Menorrhagia / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009336:Necrosis; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012008:Recurrence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D063189:Symptom Assessment; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000706:statistics & numerical data*; D014599:Uterus / Q000473:pathology*