Document Detail


Uterine Artery Embolization for Uterine Leiomyoma: Role of Uterine Artery Doppler in the Pre-Interventional, Interventional and Post-interventional Patient Workup.
MedLine Citation:
PMID:  22173924     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: To study Doppler changes in the uterine artery immediately and 3 months after uterine artery embolization (UAE) and to test the feasibility of using uterine artery Doppler as a predictor of the predominant side of arterial supply to leiomyomas, amount of embolizing material needed and leiomyoma tumor volume at follow-up. MATERIALS AND METHODS: The study was performed on 38 patients to whom UAE was performed. Uterine artery Doppler was performed trans-abdominally before, within 6 hours and 3 months after UAE to determine the peak systolic (PSV) and end diastolic (EDV) velocities and resistive index (RI). Leiomyoma volume was measured using contrast enhanced MRI before and 3 months after UAE. The predominant side of arterial supply to leiomyoma was confirmed on angiography using the uterine artery diameter and tumor blush after contrast injection. For the volume correlations the average PSV, EDV and RI of both sides was used. For prediction of the predominant side of supply and for correlation with the amount of embolizing material separate measurements from each side were used. RESULTS: Immediately following UAE the uterine artery PSV and EDV were significantly reduced (p <0.05) while the RI was significantly elevated (p <0.05) relative to the pre-embolization value. For detection of the predominant side of supply, the lowest RI showed the highest accuracy (82%) for prediction. No significant correlation was noted between the pre-embolization PSV, EDV and RI (p>0.05) and the utilized amount of embolizing material. For the leiomyoma volume, immediate post-embolization EDV and RI values showed statistically significant (p= 0.0400 and 0.0002, rho = 0.34 and -0.58 respectively) correlation with the 3 month follow-up leiomyoma volume with the RI showing the highest correlation value. The leiomyoma volume was predicted to be reduced by 38%-61% after 3 months if the immediate post-embolization average RI value was between 0.82 and 0.88 CONCLUSION: Pre-interventional Doppler assessment can be used to predict the predominant side of supply to the leiomyomas but not the amount of embolizing material needed. Post-interventional Doppler assessment can predict the leiomyoma volume after UAE. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
Nagy N N Naguib; Nour-Eldin A Nour-Eldin; Fouad Serag Eldin; Yasser Z Mazloum; Abdel Fatah Agameya; Shadia Abou Seif; Ashraf N Etaby; Thomas Lehnert; Tatjana Gruber-Roh; Stefan Zangos; Hanns Ackermann; Thomas J Vogl
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-16
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Frankfurt University Hospital, Radiology Department; Alexandria University Hospital, Radiology Department. nagynnn@yahoo.com.
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