Assessment of Uterine and Ovarian Arteries before Uterine Artery Embolization: Advantages Conferred by Unenhanced MR Angiography

Abstract

To clarify the benefits of unenhanced magnetic resonance (MR) angiography in planning uterine artery embolization (UAE). This retrospective study was approved by the institutional review board, and the informed consent requirement was waived. Fifty-five consecutive women (mean age, 42 years; age range, 26-52 years) who underwent UAE for symptomatic uterine fibroids were placed chronologically into groups 1, 2, or 3, which were composed of 20, 22, and 13 patients, respectively. Digital subtraction angiography was performed in groups 1 and 2 but not in group 3. In the 35 patients in groups 2 and 3, unenhanced MR angiography was performed before UAE, and two independent radiologists assessed the results. The parameters indicating performance of UAE were compared among the three groups with the Tukey test. Forty-five patients underwent routine UAE (19, 16, and 10 patients in groups 1, 2, and 3, respectively). Sixty-eight (97%) of 70 uterine artery origins were demonstrated clearly at MR angiography. Among five ovarian arteries detected at MR angiography, collateral supply was confirmed in four (80%). The assessment of MR angiographic results and discontinuation of digital subtraction angiography led to a reduction in the mean performance time (from 96.2 minutes to 51.9 minutes [P = .004]), fluoroscopy time (from 28.5 minutes to 17.8 minutes [P = .036]), dose-area product (from 109.8 Gy.cm(2) to 25.4 Gy.cm(2) [P < .001]), and contrast medium volume (from 103.8 mL to 40.8 mL [P < .001]). Unenhanced MR angiography provides useful information regarding uterine and ovarian arteries before UAE.