Long-term MR Imaging after Uterine Artery Embolization for Symptomatic Adenomyosis

Shin Jae Lee, Man Deuk Kim, Hyun‐Seok Lee, Mee Hwa Lee, Han Jo Kim, Hee Jin Kim, Jin Ho Cho, Sun Hee
In: Journal of the Korean Society of Radiology · 2009 · vol. 60(5) , pp. 347 · doi:10.3348/jksr.2009.60.5.347 · W2306052896
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Long-term MRI after uterine artery embolization for adenomyosis revealed persistent necrosis/atrophy, viable tissue replacement, or global uterine enlargement.

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This study evaluated long-term follow-up magnetic resonance imaging findings in 22 patients who underwent uterine artery embolization for symptomatic adenomyosis between 1998 and 2000. Researchers analyzed contrast-enhanced MR images taken before the procedure and more than three years afterward to assess changes in lesion volume and necrosis status across focal and diffuse disease types. The results identified three primary patterns of tissue response: persistent necrosis or atrophy, replacement of previously necrotized areas with viable tissue showing contrast enhancement, and global enlargement of the uterus. This paper is centrally about adenomyosis — specifically the long-term radiological outcomes following uterine artery embolization treatment.

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Abstract

Purpose: We wanted to assess the long-term follow-up MR (LTFU-MR) imaging of adenomyosis that was treated with uterine artery embolization (UAE). Materials and Methods: From 1998 to 2000, 22 patients who underwent UAE for symptomatic adenomyosis were enrolled. The pattern of adenomyosis was divided into two categories: focal (n=14) and diffuse type (n=8). All the patients underwent contrast-enhanced MR imaging 3 months before embolization and over 3 years after embolization. The MR findings for the volume change and the existence and alteration of necrosis were analyzed. Results: In the focal adenomyosis, LTFU-MR revealed contrast enhancement in the completely necrotized area before in five out of seven patients and persistent necrosis with atrophy in the remaining two cases. In the six cases without necrosis, four showed global enlargement of the uterus. In the eight patients with diffuse adenomyosis, LTFU-MR revealed contrast enhancement in the necrotized area in four of the patients. Of the remaining four patients who had no necrosis, two showed global enlargement of the uterus. Conclusion: LTFU-MR revealed three common patterns: persistent necrosis or atrophy, viable tissue replacement in the previously necrotized area and global enlargements of the uterus.
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Abstract

Purpose We wanted to assess the long-term follow-up MR (LTFU-MR) imaging of adenomyosis that was treated with uterine artery embolization (UAE).

Materials and methods

From 1998 to 2000, 22 patients who underwent UAE for symptomatic adenomyosis were enrolled. The pattern of adenomyosis was divided into two categories: focal (n=14) and diffuse type(n=8). All the patients underwent contrast-enhanced MR imaging 3 months before embolization and over 3 years after embolization. The MR findings for the volume change and the existence and alteration of necrosis ere analyzed.

Results

In the focal adenomyosis, LTFU-MR revealed contrast enhancement in the completely necrotized area before in five out of seven patients and persistent necrosis with atrophy in the remaining two cases. In the six cases without necrosis, four showed global enlargement of the uterus. In the eight patients with diffuse adenomyosis, LTFU-MR revealed contrast enhancement in the necrotized area in four of the patients. Of the remaining four patients who had no necrosis, two showed global enlargement of the uterus.

Conclusion

LTFU-MR revealed three common patterns: persistent necrosis or atrophy, viable tissue replacement in the previously necrotized area and global enlargements of the uterus.

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