Preprocedural MRI and MRA in planning fibroid embolization.
This pictorial review aims to discuss and illustrate the up-to-date use of preprocedural magnetic resonance imaging (MRI) in selecting patients and planning uterine artery embolization (UAE). The merits of magnetic resonance angiography (MRA) in demonstrating the pelvic vasculature to guide UAE are highlighted. MRI features of fibroids and their main differential diagnoses are presented. Fibroid characteristics, such as location, size, and enhancement, which may impact patient selection and outcome, are presented based on recent literature. Pelvic arterial anatomy relevant to UAE, including vascular variants are illustrated, with conventional angiography and MRA imaging correlation. MRA preprocedural determination of the optimal projection angles for uterine artery catheterization is straightforward and constitutes an important strategy to minimize ionizing radiation exposure during UAE. A reporting template for MRI/MRA preassessement of UAE for fibroid treatment is provided.
Department of Radiology, Centro Hospitalar São João, Porto, Portugal. tina_maciel@yahoo.com.
Cristina
C
Maciel
Yen Zhi
YZ
Tang
Anju
A
Sahdev
António Miguel
AM
Madureira
Paulo
P
Vilares Morgado
D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging* / Q000628:therapy; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010388:Pelvis / Q000098:blood supply* / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000379:methods