Nagy Naguib Naeem Naguib MD, MSc, Presenter: Nothing to Disclose

Nour-Eldin Abdelrehim Nour-Eldin MD, MSc, Abstract Co-Author: Nothing to Disclose

Tatjana Gruber-Rouh, Abstract Co-Author: Nothing to Disclose

Thomas Lehnert MD, Abstract Co-Author: Nothing to Disclose

Renate Maria Hammerstingl MD, Abstract Co-Author: Nothing to Disclose

Stefan Zangos MD, Abstract Co-Author: Nothing to Disclose

Thomas Josef Vogl MD, PhD, Abstract Co-Author: Nothing to Disclose

To study the different post-embolization leiomyoma enhancement patterns on MRI and to test if the enhancement pattern correlates with the leiomyoma volume change at 3 month follow-up after successful uterine artery embolization (UAE), enabling its use as one of the parameters predicting embolization outcome.

The study was retrospectively performed on 40 females (Age Range: 33-55 years, Mean: 45.6 +/- 4.48). MRI was performed immediately after UAE (within 6 hours) & the pattern of enhancement of the individual leiomyomas was identified. We identified 5 patterns of enhancement: total absence of enhancement (total devascularization), focal mural enhancement (subtotal devascularization), combined large areas of none enhancement & enhancement (partial devascularization), heterogeneous or mottled enhancement (inadequate devascularization) & homogenous enhancement (failed devascularization). Overall 116 leiomyomas were evaluated. The volume of each leiomyoma was calculated before and 3 months after UAE using contrast-enhanced MRI. Correlation was tested using Spearman Rank & analysis of variance (ANOVA) tests.

Before UAE the mean leiomyoma volume was 67.37 ml +/- 128.3 (Range: 1.33–987.34 ml). At 3 month follow-up the mean leiomyoma volume was 45.67 ml +/- 107.25 (Range: 0.15–875.05). The mean volume change percentage after 3 months was 50.81% [volume reduction] +/- 27.49 (Range: 40.05% [increase] – 96.57% [reduction]). Total devascularization was encountered in 73 leiomyomas & showed a mean volume reduction of 64.48%, subtotal devascularization (n=15) with 51.93% reduction, partial devascularization (n=8) with 31.95% reduction, inadequate devascularization (n=16) with 14.05% reduction & failed devascularization (n=4) with 18.12% volume increase. A statistically significant (p<0.0001) substantial correlation (rho= -0.7) between the post-embolization leiomyoma enhancement pattern & the percentage of volume change at 3 month follow-up was noted.  

Five different patterns of leiomyoma enhancements can be encountered following UAE. A statistically significant substantial correlation was detected between the post-embolization leiomyoma enhancement pattern and the 3 month follow-up volume change.

The post-embolization pattern of leiomyoma enhancement can predict the percentage of leiomyoma volume change at 3 month follow-up with total absent enhancement showing the most favorable results.

Naguib, N, Nour-Eldin, N, Gruber-Rouh, T, Lehnert, T, Hammerstingl, R, Zangos, S, Vogl, T, MR-Imaging Immediately after Uterine Artery Embolization: Post-embolization Leiomyoma Enhancement Patterns and Their Effect on the Leiomyoma Volume Change at Follow-up    .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009258.html