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Submucosal Fibroids Becoming Endocavitary Following Uterine Artery Embolization: Risk Assessment by MRI

¹ Department of Radiology, Thomas Jefferson University Hospital, 396C Main Bldg., 111 S 10th St., Philadelphia, PA 19107.
² Present address: Department of Radiology, Galway University Hopital, Newcastle Rd., Galway, Co. Galway, Ireland.
³ Present address: Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA.

View larger version (114K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —56-year-old woman with fibroids. Baseline sagittal fat-suppressed fast spin-echo T2-weighted MR image shows calculation of interface of fibroid with endometrium (em) (xy + yz = xz) and maximum submucosal fibroid dimension (ab). Interface–dimension ratio calculated by (xz / ab).

View larger version (121K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —43-year-old woman with submucosal (SM) fibroid. Sagittal fat-suppressed fast spin-echo T2-weighted MR image (TR/TE, 2,800/85) before uterine artery embolization (UAE) shows submucosal fibroid with broad interface with endometrium (em) (arrows). Interface–dimension ratio is 0.76.

View larger version (125K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —43-year-old woman with submucosal (SM) fibroid. Sagittal fat-suppressed fast spin-echo T2-weighted MR image (2,800/85) after UAE shows submucosal fibroid that became completely endocavitary (EC). em = endometrium.

View larger version (134K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —41-year-old woman with submucosal fibroid. Axial T2-weighted fast spin-echo image (TR/TE, 2,800/85) before uterine artery embolization (UAE) shows submucosal fibroid (asterisk) with interface–dimension ratio of 0.67.

View larger version (149K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —41-year-old woman with submucosal fibroid. Axial T2-weighted fast spin-echo image (2,800/85) after UAE shows submucosal fibroid (asterisk), which became partially endocavitary.

View larger version (169K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —42-year-old woman with intramural fibroid. Axial T2-weighted fast spin-echo image (TR/TE, 4,000/90) before uterine artery embolization (UAE) shows intramural fibroid within myometrium (arrows). IM = intramural fibroid, em = endometrium.

View larger version (158K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —42-year-old woman with intramural fibroid. Axial fast spin-echo T2-weighted MR image (4,000/90) after UAE shows intramural fibroid that became submucosal (SM). em = endometrium.

View larger version (87K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5 —Hysteroscopic resection of necrotic fibroid in 43-year-old woman. Fibroid changed location from submucosal to endocavitary after uterine artery embolization. Photomicrograph of fibroid shows coagulative necrosis. (H and E, x400)

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