Gadolinium-Enhanced MR Imaging in the Evaluation of Uterine Fibroids Treated with Uterine Artery Embolization

Abstract

OBJECTIVE. The purpose of this study was to determine whether tumor volume reduction can be predicted by the infarction rate of uterine fibroids as seen on gadolinium-enhanced MR images obtained immediately after uterine artery embolization. MATERIALS AND METHODS. In our study, 36 women with symptomatic uterine fibroids successfully underwent uterine artery embolization. Unenhanced and enhanced MR imaging was performed before the procedure and repeated at 1 week, 4 months, and 1 year after the procedure. We retrospectively reviewed enhanced MR images of uterine fibroids after uterine artery embolization. At 4 months after uterine artery embolization, we compared the rate of tumor volume reduction in patients with completely infarcted dominant fibroids with the rate of tumor volume reduction in patients with partially infarcted fibroids. RESULTS. Enhanced MR images obtained 1 week after uterine artery embolization revealed that 100% infarction rates of the dominant uterine fibroids were achieved in 33 women (92%), and 70-90% infarction rates were seen in the remaining three (8%). They also revealed that of a total of 204 fibroids in these patients, 100% infarction was achieved in 199 fibroids (98%). Enhanced MR images obtained 4 months after uterine artery embolization showed that tumor volume reduction of the completely infarcted dominant fibroids (n = 23) was 60% ± 18%, whereas that of the partially infarcted fibroids (n = 5) was 35% ± 27% (p = 0.0367). CONCLUSION. Gadolinium-enhanced MR imaging is a useful diagnostic technique for uterine fibroids after uterine artery embolization because it assesses the degree of infarction in the embolized fibroids, which corresponds to the subsequent tumor volume reduction.