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Predicting the Fibroid-Migratory Impact of UAE: Role of Pre-embolization MRI Characteristics

CardioVascular and Interventional Radiology, ISSN: 1432-086X, Vol: 43, Issue: 3, Page: 453-458
2020
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Article Description

Aim: To investigate potential factors on MR imaging that could be used to predict migration of uterine fibroids post-UAE. Methods and Materials: We retrospectively reviewed patients referred for UAE having pre-procedural and 6 months post-procedural MRI, at a tertiary centre, over a 1-year period. Pre- and post-UAE images were reviewed in 64 women by two radiologists to identify the sub-type, dimensions, and infarction rate of each dominant fibroid. The shortest distance between the fibroid and the endometrial wall was measured to determine intramural fibroid movement. Paired sample T tests and two-sample T tests were used to compare between pre- and post-embolization variations and between migrated and non-migrated intramural fibroids, respectively. After preliminary results suggested potential predictors of intramural fibroids migration, we tested our findings against the non-dominant intramural fibroids in the same patients. Results: Review of images revealed 35 dominant intramural fibroids, of which eight migrated to become submucosal fibroids, while five were either partially or completely expelled. These 13 migrated fibroids had a shorter pre-procedural minimum endometrial distance (range 1–2.4 mm) and greater maximum fibroid diameter (range 5.1–18.1 cm), when compared to non-migrating fibroids. On image reassessment, the migrated non-dominant intramural fibroids had a minimum endometrial distance and maximum fibroid diameter within the same range. Conclusion: Intramural fibroids with a minimum endometrial distance less than 2.4 mm and a maximum fibroid diameter greater than 5.1 cm have a high likelihood of migrating towards the endometrial cavity after UAE.

Bibliographic Details

Mailli, Leto; Auyoung, Eric Y; Angileri, Salvatore A; Ameli-Renani, Seyed; Ratnam, Lakshmi; Das, Raj; Chun, Joo-Young; Das, Sourav; Manyonda, Isaac; Belli, Anna-Maria

Springer Science and Business Media LLC

Medicine

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