Improved infarction rates in fibroids after the introduction of contrast-enhanced ultrasound during uterine artery embolization.

ABSTRACT

BACKGROUND: In order to achieve sustained symptom control and minimize the risk of recurrence, uterine artery embolization (UAE) should aim at complete infarction of all fibroids. PURPOSE: To retrospectively evaluate the infarction rate of uterine fibroids in patients that had undergone uterine artery embolization (UAE) after the introduction of contrast-enhanced ultrasound (CEUS) during UAE procedures at our institution. MATERIAL AND METHODS: Thirty patients treated with UAE between February 2006 and August 2009 were included. MR images obtained before, at 3 months, and 12 months after the procedure were reviewed. We evaluated volume changes in dominant fibroids as well as the infarction rate of all fibroids in each patient. Clinical results were evaluated by reviewing the medical records. The study was approved by the institutional review board. RESULTS: CEUS was technically successfully performed during the UAE procedure in all patients. In five cases the endpoint of embolization was adjusted based on findings at CEUS. The mean volume shrinkage of dominant fibroids was 39.8% after 3 months and 59.8% after 12 months. There was complete infarction of all fibroid tissue in 97% of patients at 3 months and 96% at 12 months. No major complications were observed. CONCLUSION: After the introduction of CEUS during UAE procedures in our institution, high infarction rates were achieved.