Olivier Sutter1, Philippe Soyer1,2,3, Eimad Shotar1, Raphael Dautry1,2, Youcef Guerrache1, Vinciane Placé1, Raluca Opréa1, Aude Ricbourg4, Olivier Le Dref1, Mourad Boudiaf1, Marc Sirol1,2, Anthony Dohan5,6,7. 1. Department of Body and Interventional Imaging, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. 2. Université Paris-Diderot, Sorbonne Paris Cité, 10 rue de Verdun, 75010, Paris, France. 3. UMR INSERM 965, Hôpital Lariboisière, 2 rue Amboise Paré, 75010, Paris, France. 4. Department of Obstetrics and Gynecology, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. 5. Department of Body and Interventional Imaging, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. anthony.dohan@aphp.fr. 6. Université Paris-Diderot, Sorbonne Paris Cité, 10 rue de Verdun, 75010, Paris, France. anthony.dohan@aphp.fr. 7. UMR INSERM 965, Hôpital Lariboisière, 2 rue Amboise Paré, 75010, Paris, France. anthony.dohan@aphp.fr.
Abstract
PURPOSE: To test whether variations in apparent diffusion coefficient (ADC) values of uterine leiomyomas after uterine artery embolization (UAE) may correlate with outcome and assess the effects of UAE on leiomyomas and normal myometrium with magnetic resonance imaging (MRI). METHODS: Data of 49 women who underwent pelvic MRI before and after UAE were retrospectively reviewed. Uterine and leiomyoma volumes, ADC values of leiomyomas, and normal myometrium were calculated before and after UAE. RESULTS: By comparison with baseline ADC values, a significant drop in leiomyoma ADC was found at 6-month post-UAE (1.096 × 10(-3) mm(2)/s vs. 0.712 × 10(-3) mm(2)/s, respectively; p < 0.0001), but not at 48-h post-UAE. Leiomyoma devascularization was complete in 40/49 women (82 %) at 48 h and in 37/49 women (76 %) at 6 months. Volume reduction and leiomyoma ADC values at 6 months correlated with the degree of devascularization. There was a significant drop in myometrium ADC after UAE. Perfusion defect of the myometrium was observed at 48 h in 14/49 women (28.5 %) in association with higher degrees of leiomyoma devascularization. CONCLUSION: Six months after UAE, drop in leiomyoma ADC values and volume reduction correlate with the degree of leiomyoma devascularization. UAE affects the myometrium as evidenced by a drop in ADC values and initial myometrial perfusion defect. KEY POINTS: • A drop in leiomyoma ADC values is observed 6 months after UAE. • Drop in leiomyoma ADC value is associated with leiomyoma devascularizarion after UAE. • MR 48 h post-UAE allows assessing leiomyoma devascularization. • Myometrium perfusion defect occurs more often in women with a smaller uterus.
PURPOSE: To test whether variations in apparent diffusion coefficient (ADC) values of uterine leiomyomas after uterine artery embolization (UAE) may correlate with outcome and assess the effects of UAE on leiomyomas and normal myometrium with magnetic resonance imaging (MRI). METHODS: Data of 49 women who underwent pelvic MRI before and after UAE were retrospectively reviewed. Uterine and leiomyoma volumes, ADC values of leiomyomas, and normal myometrium were calculated before and after UAE. RESULTS: By comparison with baseline ADC values, a significant drop in leiomyoma ADC was found at 6-month post-UAE (1.096 × 10(-3) mm(2)/s vs. 0.712 × 10(-3) mm(2)/s, respectively; p < 0.0001), but not at 48-h post-UAE. Leiomyoma devascularization was complete in 40/49 women (82 %) at 48 h and in 37/49 women (76 %) at 6 months. Volume reduction and leiomyoma ADC values at 6 months correlated with the degree of devascularization. There was a significant drop in myometrium ADC after UAE. Perfusion defect of the myometrium was observed at 48 h in 14/49 women (28.5 %) in association with higher degrees of leiomyoma devascularization. CONCLUSION: Six months after UAE, drop in leiomyoma ADC values and volume reduction correlate with the degree of leiomyoma devascularization. UAE affects the myometrium as evidenced by a drop in ADC values and initial myometrial perfusion defect. KEY POINTS: • A drop in leiomyoma ADC values is observed 6 months after UAE. • Drop in leiomyoma ADC value is associated with leiomyoma devascularizarion after UAE. • MR 48 h post-UAE allows assessing leiomyoma devascularization. • Myometrium perfusion defect occurs more often in women with a smaller uterus.
Authors: J P Pelage; O Le Dref; P Soyer; D Jacob; M Kardache; H Dahan; J P Lassau; R Rymer Journal: AJR Am J Roentgenol Date: 1999-04 Impact factor: 3.959
Authors: Yuri Kitamura; Susan M Ascher; Cirrelda Cooper; Sandra J Allison; Reena C Jha; Pamela A Flick; James B Spies Journal: Radiographics Date: 2005-10 Impact factor: 5.333