MRI Enhancement as A Predicator of Uterine Fibroid Volume Reduction after Embolism

Al Mehdar, Amor Abdullah; Tukruna, Alaa Ibrahim; Alotaibi, Abdulaziz Raja Najim; Alshahrani, Alaa Mohammed Ali; Alsaad, Fatimah Nasser; Jaffa, Zahra Adel Ali; Aljohan, Azharmuslimsarhan; Alqarrash, Zahra Ibrahim; Alluhaybi, Hajarayad; Aludaini, Afnan Omer; Hakami, Luayesam; Alanzi, Amnah Abdullah; Muharib, Abdullah Abdulrahman I; Althumairy, Abdulsalam Ibrahim A.; Alyami, Atheer Raja

doi:10.12816/0041526

MRI Enhancement as A Predicator of Uterine Fibroid Volume Reduction after Embolism

Document Type : Original Article

Authors

¹ Ministry of Health

² Batterjee Medical College

³ King Faisal Medical Complex

⁴ King Khalid University

⁵ Imam Abdulrahman Bin Faisal University

⁶ Almaarefa Colleges

⁷ Taibah University

⁸ King Abdulaziz University

⁹ Umm Al-Qura University

¹⁰ University of Tabuk

¹¹ King Saud Bin Abdulaziz University for Health Sciences

¹² Najran University

10.12816/0041526

Abstract

Aim of the Study: To evaluate the response of necrotic fibroids to UAE and to identify whether pre-UAE enhancement or other factors are predictors of fibroid shrinkage.
Materials and methods: This is a retrospective review of all women who underwent UAE for symptomatic fibroids from January 2013 till July 2017, who experienced a follow-up MRI 5-6 months after UAE were included. There were 54 fibroids (37 non-enhancing and 17 enhancing) among 24 women with a mean age of 56 (range 40-59) years. All fibroids were assessed for size, position, enhancement on subtraction images, and Apparent Diffusion Constant (ADC).
Results: Enhancing fibroids had an average decrease in diameter by 23 ± 6%, not significantly different compared to that non-enhancing fibroids which decreased by 19 ± 3% (p=0.491). Multiple linear regression with percent change in fibroid diameter as the dependent variable and patient age, fibroid position, and pre-UAE fibroid diameter, enhancement, and ADC as independent variables, showed that ADC (p<0.005) and pre-UAE diameter (p<0.005) were the only significant independent variables.
Conclusion: Pre-UAE size and ADC, but not contrast enhancement, predicted fibroid diameter reduction. Enhancing and non-enhancing fibroids had similar size reduction after UAE. Non-enhancement should not be considered a contraindication to UAE.

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