Abstract
BackgroundFibroids are the most common uterine tumor in the reproductive age group. These tumors although benign, their relation to infertility is still controversial. The purpose of this study is to assess the fibroid impact on fertility using arterial spin labeling (ASL) technique.ResultsThis prospective study included 40 cases (30 female patients having uterine fibroid and 10 age- and sex-matched control cases). The 30 patients were divided according to their fertility into 2 subgroups: fertile (n = 15) and infertile (n = 15). All cases underwent pelvic magnetic resonance imaging (MRI) examination with ASL technique. The perfusion values were measured in the uterine walls, fibroids, and in the gluteus maximus muscle as control. ASL demonstrated non-significant difference in the perfusion between anterior and posterior uterine walls in the control cases and revealed significant difference in the perfusion between fibroid positive and fibroid negative uterine walls in patients with uterine fibroid (p value < 0.04). Perfusion values of the fertile and infertile subgroups showed no statistically significant difference.ConclusionArterial spin labeling is an evolving technique that can be used to evaluate the myometrial perfusion changes in patients with uterine fibroid without using contrast media. Uterine fibroids were associated with decreased perfusion but with no statistically significant impact on fertility.
Highlights
Fibroids are the most common uterine tumor in the reproductive age group
magnetic resonance imaging (MRI) perfusion analysis with arterial spin labeling (ASL) In the control group, no statistically significant difference was detected as regards the perfusion indices between the anterior and posterior uterine walls (p value = 0.7)
In patients with uterine fibroid, the positive wall perfusion indices were significantly lower than the negative wall perfusion indices (p value = 0.04*), and this difference was noted in both fertile and infertile subgroups (Figs. 3 and 4)
Summary
Fibroids are the most common uterine tumor in the reproductive age group These tumors benign, their relation to infertility is still controversial. Fibroids are the most common uterine tumor in the reproductive age group affecting 20–50% of women at this age These tumors benign, their relation to infertility is still controversial and is always of great concern to the clinician as well as the patient [1, 2]. They are often asymptomatic, but they can cause multiple symptoms such as abnormal uterine bleeding, feeling of pelvic pressure, urinary retention, or pain. Intramural fibroids are the most common type, but they are usually asymptomatic; they may cause infertility due to compression of the fallopian
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