Gadolinium-enhanced MR imaging in the evaluation of uterine fibroids treated with uterine artery embolization

OBJECTIVE. The purpose of this study was to determine whether tumor volume reduction can be predicted by the infarction rate of uterine fibroids as se en on gadolinium-enhanced MR images obtained immediately after uterine arte ry embolization. MATERIALS AND METHODS. In our study, 36 women with symptomatic uterine fibr oids successfully underwent uterine artery embolization. Unenhanced and enh anced MR imaging was performed before the procedure and repeated at 1 week, 4 months, and 1 year after the procedure. We retrospectively reviewed enha nced MR images of uterine fibroids after uterine artery embolization. At 4 months after uterine artery embolization, we compared the rate of tumor vol ume reduction in patients with completely infarcted dominant fibroids with the rate of tumor volume reduction in patients with partially infarcted fib roids. RESULTS. Enhanced MR images obtained 1 week after uterine artery embolizati on revealed that 100% infarction rates of the dominant uterine fibroids wer e 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%). Enhanc ed MR images obtained 4 months after uterine artery embolization showed tha t 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 t he subsequent tumor volume reduction.