This retrospective study analyzed the percentage of necrosis of uterine adenomyosis on contrast-enhanced MR imaging in 50 women who underwent the procedure for symptomatic adenomyosis. Three dimensional reconstruction software was used to measure the volumes of adenomyosis on the baseline scan and the necrotic volume at the 3 month follow up scan, as defined by non-enhancement on T1-weighted post contrast images. Adenomyosis-related symptoms were assessed using an oral questionnaire at baseline and up to 48 months post-procedure.
During the follow up period, symptom recurrence occurred in 24% (12 of 50) of women. Women with < 34.3% necrosis after UAE had a sevenfold higher risk of symptom recurrence compared with patients with > 34.3% necrosis. Initial uterine volume and the type of adenomyosis (focal or diffuse) did not show significant relationships with recurrence. The study was limited by a small number of patients at a single institution. The distribution of the percentage of necrosis found in the patients was heavily skewed in that 38 out of 50 women had > 34% necrosis.
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Citation: Bae, S. H. et al. Uterine Artery Embolization for Adenomyosis: Percentage of Necrosis Predicts Midterm Clinical Recurrence. Journal of Vascular and Interventional Radiology (2015). doi:10.1016/j.jvir.2015.04.026
Author: Laura Traube, MD, MPH, Fellow in Interventional Radiology, UCLA Medical Center