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 incidence, pattern, extent and fate of endometrial and myometrial ischemia as one of the forms of none target embolization following successful uterine artery embolization (UAE) as detected on immediate post-embolization and 3 month follow-up contrast enhanced MRI examinations.

The study was retrospectively performed on 43 females (Age Range: 33-52 years, Mean: 44.8 +/- 3.79). MRI was performed immediately after (within 6 hours) and 3 months after successful UAE. Areas of endometrial & myometrial ischemia were identified on the immediate post-embolization MRI as regions of newly developed (compared to pre-embolization MRI) absent enhancement within the uterus not corresponding to the location of the leiomyomas. The volume of the ischemic region was calculated using the formula for ellipsoid volumes (Height X Length X Width X 0.523). Possible change in volume of the ischemic area after 3 months was tested for statistical significance using One-Sample paired t-Test.  

Of the included 43 patients; post-embolization endometrial & myometrial ischemia was encountered in 29 patients (incidence = 67.44%). In all cases the ischemic region was seen as a newly developed irregular centrally located region of absent enhancement involving both the endometrium & myometrium. The mean volume of the ischemic region immediately after UAE was 29.29 ml +/- 19.15 (Range: 7.36 – 87.71 ml). At 3 month follow-up it was 0.35 ml +/- 0.95 (Range: 0 – 3.5 ml) with 25 (86%) patients showing complete resolution of the ischemia. The mean reduction in the volume of the ischemic region at 3 month follow-up was 98.24% +/- 5.72 (Range: 72 – 100%). A statistically significant reduction in the volume of the endometrial & myometrial ischemic was noted (p < 0.0001).

Endometrial & myometrial ischemic regions as a form of none target embolization following UAE might be encountered in up to two thirds of patients in the form of irregular centrally located regions of absent enhancement. These ischemic areas are significantly reduced at 3 month follow-up with up to 86% of cases showing completely reversibility of the ischemia.

The post-embolization ischemia of the endometrium and myometrium is not a rare encounter following uterine artery embolization with excellent outcome and complete reversibility in up to 86% of cases.

Naguib, N, Nour-Eldin, N, Gruber-Rouh, T, Lehnert, T, Hammerstingl, R, Zangos, S, Vogl, T, Endometrial and Myometrial Ischemia as a Form of None Target Embolization Following Uterine Artery Embolization: Incidence, Pattern, Extent and Fate.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010521.html