Degeneration of Leiomyoma in Patients Referred for Uterine Fibroid Embolization: Incidence, Imaging Features and Clinical Characteristics.
10.3349/ymj.2013.54.1.215
- Author:
Seung Chul HAN
1
;
Man Deuk KIM
;
Dae Chul JUNG
;
Myungsu LEE
;
Mu Sook LEE
;
Sung Il PARK
;
Jong Yun WON
;
Do Yun LEE
;
Kwang Hun LEE
Author Information
1. Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. mdkim@yuhs.ac
- Publication Type:Original Article
- Keywords:
Uterine artery embolization;
magnetic resonance imaging;
degeneration;
leiomyoma;
uterus
- MeSH:
Abdominal Pain/therapy;
Adult;
Female;
Follow-Up Studies;
Humans;
Incidence;
Leiomyoma/*complications/epidemiology/*pathology/*surgery;
Magnetic Resonance Imaging;
Menorrhagia/therapy;
Middle Aged;
Pregnancy;
Retrospective Studies;
Treatment Outcome;
*Uterine Artery Embolization
- From:Yonsei Medical Journal
2013;54(1):215-219
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Imaging features and clinical characteristics of degenerated leiomyoma in patients referred for uterine fibroid embolization (UFE) were analyzed to assess the incidence of degenerated leiomyoma. MATERIALS AND METHODS: Patients referred for UFE between 2008 and 2009 were retrospectively analyzed (n=276). Patients ranged in age from 27 to 51 years (mean 38.0 years). All patients underwent screening MRI with contrast enhancement. Medical histories and clinical symptoms were evaluated. RESULTS: Among the 276 patients who underwent MRI, 14 (5.1%) showed degenerated leiomyomas. Symptoms were abdominal pain (n=4, 26.7%), menorrhagia (n=5, 35.7%) and bulk-related symptoms (n=5, 35.7%) and no symptoms (n=5, 35.7%). Of the 14 patients with degenerated leiomyomas, 5 (42.9%) had a history of pregnancy in the past two years. For T1-weighted imaging (T1WI), a high signal intensity (SI) of the leiomyoma was the most common finding (n=9, 64.3%) and a hyperintense rim (n=4, 28.6%) was the second most common. On T2-weighted imaging (T2WI), a low SI of the leiomyoma was found in six patients (42.9%), a high SI in four (28.6%) and a heterogeneous SI in four (28.6%) patients. Conservative management was performed in 11 (78.6%) patients, surgery in 3 (21.4%) and uterine artery embolization in one (7.1%) patient. CONCLUSION: The incidence of degeneration of leiomyoma in patients referred for UFE was 5.1%. Patients presented with variable clinical symptoms with or without a history of pregnancy. MR imaging showed a high SI on T1WI and various SIs on T2WI without contrast enhancement. An understanding of the degeneration of leiomyomata is essential when considering UFE.
