Incidence of Nonviable Leiomyomas on Contrast Material–Enhanced Pelvic MR Imaging in Patients Referred for Uterine Artery Embolization

Abstract

To assess the incidence of nonviable leiomyomas in patients referred for uterine artery embolization (UAE) with use of contrast material-enhanced pelvic magnetic resonance (MR) imaging and to determine the effect of this information on interventional radiologists' decision to perform UAE or consider other treatment options. One hundred consecutive women referred for UAE for treatment of symptomatic leiomyomas were studied. Of these, 94 patients underwent MR imaging examinations, which were retrospectively reviewed. Leiomyoma locations (ie, submucosal, intramural, subserosal), volume (length, width, height), and percent nonenhancement were recorded and the measurements were divided into four categories (0-25%, 25%-50%, 50%-75%, 75%-100%). In 94 patients, 381 leiomyomas exceeding 3 cm in each dimension were recorded. Twenty-one patients (22%) did not receive embolization based on the findings of preprocedural MR imaging. In six patients (6%), there were nine nonviable dominant tumors with an average size of 7.8 cm3. These cases were not treated with UAE. Another 15 patients (16%) did not undergo UAE based on other MR imaging findings (including uterine size, presence of isolated adenomyosis, and endometrial lesions). Contrast material-enhanced MR imaging before UAE is highly useful in the evaluation of patients referred for UAE. MR imaging can be used to determine the viability of tumors and detect other findings that preclude UAE.