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Degeneration of Leiomyoma in Patients Referred for Uterine Fibroid Embolization: Incidence, Imaging Features and Clinical Characteristics
Yonsei Medical Journal ; : 215-219, 2013.
Article in English | WPRIM | ID: wpr-17427
ABSTRACT

PURPOSE:

Imaging features and clinical characteristics of degenerated leiomyoma in patients referred for uterine fibroid embolization (UFE) were analyzed to assess the incidence of degenerated leiomyoma. MATERIALS AND

METHODS:

Patients referred for UFE between 2008 and 2009 were retrospectively analyzed (n=276). Patients ranged in age from 27 to 51 years (mean 38.0 years). All patients underwent screening MRI with contrast enhancement. Medical histories and clinical symptoms were evaluated.

RESULTS:

Among the 276 patients who underwent MRI, 14 (5.1%) showed degenerated leiomyomas. Symptoms were abdominal pain (n=4, 26.7%), menorrhagia (n=5, 35.7%) and bulk-related symptoms (n=5, 35.7%) and no symptoms (n=5, 35.7%). Of the 14 patients with degenerated leiomyomas, 5 (42.9%) had a history of pregnancy in the past two years. For T1-weighted imaging (T1WI), a high signal intensity (SI) of the leiomyoma was the most common finding (n=9, 64.3%) and a hyperintense rim (n=4, 28.6%) was the second most common. On T2-weighted imaging (T2WI), a low SI of the leiomyoma was found in six patients (42.9%), a high SI in four (28.6%) and a heterogeneous SI in four (28.6%) patients. Conservative management was performed in 11 (78.6%) patients, surgery in 3 (21.4%) and uterine artery embolization in one (7.1%) patient.

CONCLUSION:

The incidence of degeneration of leiomyoma in patients referred for UFE was 5.1%. Patients presented with variable clinical symptoms with or without a history of pregnancy. MR imaging showed a high SI on T1WI and various SIs on T2WI without contrast enhancement. An understanding of the degeneration of leiomyomata is essential when considering UFE.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Magnetic Resonance Imaging / Abdominal Pain / Incidence / Retrospective Studies / Follow-Up Studies / Treatment Outcome / Uterine Artery Embolization / Leiomyoma / Menorrhagia Type of study: Incidence study / Observational study / Prognostic study / Risk factors Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Yonsei Medical Journal Year: 2013 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Magnetic Resonance Imaging / Abdominal Pain / Incidence / Retrospective Studies / Follow-Up Studies / Treatment Outcome / Uterine Artery Embolization / Leiomyoma / Menorrhagia Type of study: Incidence study / Observational study / Prognostic study / Risk factors Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Yonsei Medical Journal Year: 2013 Type: Article