ABSTRACT
Aim of the Study: To evaluate the response of necrotic fibroids to UAE and to identify whether pre-UAE enhancement or other factors are predictors of fibroid shrinkage
Materials and methods: This is a retrospective review of all women who underwent UAE for symptomatic fibroids from January 2013 till July 2017, who experienced a follow-up MRI 5-6 months after UAE were included. There were 54 fibroids [37 non-enhancing and 17 enhancing] among 24 women with a mean age of 56 [range 40-59] years. All fibroids were assessed for size, position, enhancement on subtraction images, and Apparent Diffusion Constant [ADC]
Results: Enhancing fibroids had an average decrease in diameter by 23 +/- 6%, not significantly different compared to that non-enhancing fibroids which decreased by 19 +/- 3% [p=0.491]. Multiple linear regression with percent change in fibroid diameter as the dependent variable and patient age, fibroid position, and preUAE fibroid diameter, enhancement, and ADC as independent variables, showed that ADC [p<0.005] and pre-UAE diameter [p<0.005] were the only significant independent variables
Conclusion: Pre-UAE size and ADC, but not contrast enhancement, predicted fibroid diameter reduction. Enhancing and non-enhancing fibroids had similar size reduction after UAE. Non-enhancement should not be considered a contraindication to UAE