Document Detail


Effect of uterine artery embolization on uterine and leiomyoma perfusion: evidence of transient myometrial ischemia on magnetic resonance imaging.
MedLine Citation:
PMID:  20685136     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To document immediate and short-term changes in uterine perfusion after uterine artery embolization (UAE).
MATERIALS AND METHODS: Fifteen patients (median age, 42 years) underwent UAE with tris-acryl gelatin microspheres and a limited embolization protocol. Contrast-enhanced magnetic resonance imaging was performed before therapy and 1 hour (immediate), 48-72 hours (subacute), and a median of 5 months (short-term follow-up) after UAE to determine uterine and leiomyoma perfusion. Leiomyomas with a minimum diameter of 10 mm were included. Changes in regional (ie, fundus/body/cervix), zonal (ie, endometrium/inner/middle and outer myometrial layer), and leiomyoma perfusion were documented.
RESULTS: UAE was technically successful in all patients. Immediate contrast-enhanced MR imaging revealed ischemia of the uterine body and fundus. The endometrium and inner myometrial layer was involved in all 15 patients; the middle layer was also involved in 13. Ischemic defects were seen in the outer layer in one patient but never in the cervix. Subacute follow-up showed reperfusion of the myometrium in 73% of patients. Ischemic defects occurred in the endometrial and junctional zone in four patients and in the middle zone in one. Five-month follow-up showed perfusion of all uterine layers in all patients. Ten patients had complete infarction of all leiomyomas; five presented with 11 partially perfused leiomyomas.
CONCLUSIONS: Limited bilateral UAE leads to transient uterine ischemia, particularly involving the endometrium and inner and middle zone of the myometrium of the uterine body and fundus. The cervix and subserosal layer are spared. Complete reperfusion of myometrial tissue is observed within 48-72 hours in most cases, whereas ischemic leiomyomas undergo irreversible infarction.
Authors:
Christian Scheurig-Muenkler; Moritz Wagner; Tobias Franiel; Bernd Hamm; Thomas J Kroencke
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Publication Detail:
Type:  Journal Article     Date:  2010-08-03
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  21     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1347-53     Citation Subset:  IM    
Copyright Information:
Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany. christian.scheurig@charite.de
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MeSH Terms
Descriptor/Qualifier:
Acrylic Resins / therapeutic use
Adult
Contrast Media / diagnostic use
Female
Gelatin / therapeutic use
Germany
Humans
Ischemia / pathology,  physiopathology*
Leiomyoma / blood supply,  pathology,  therapy*
Magnetic Resonance Imaging*
Middle Aged
Myometrium / blood supply*
Perfusion Imaging / methods*
Prospective Studies
Regional Blood Flow
Time Factors
Treatment Outcome
Uterine Artery Embolization* / adverse effects
Uterine Neoplasms / blood supply,  pathology,  therapy*
Chemical
Reg. No./Substance:
0/Acrylic Resins; 0/Contrast Media; 0/trisacryl gelatin microspheres; 9000-70-8/Gelatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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