ABSTRACT
Tc-99m HMPAO single photon emission computed tomography was performed in a patient who had experienced aphasia for 3 days. The patient had a medical history of subarachnoid hemorrhage and intracranial hemorrhage. Both of these hemorrhages were related to a dural arteriovenous malformation that was embolized after the onset of the cerebral vascular events. Focal hyperperfusion was seen in the left temporal lobe adjacent to a perfusion defect corresponding to the old cerebral hemorrhage. The finding was interpreted as the focus of the patient's epilepsy. His aphasia resolved after the administration of anticonvulsant medication for several days.
Subject(s)
Aphasia/diagnostic imaging , Aphasia/etiology , Arteriovenous Malformations/diagnostic imaging , Epilepsy, Temporal Lobe/diagnostic imaging , Epilepsy, Temporal Lobe/etiology , Intracranial Embolism/diagnostic imaging , Intracranial Embolism/etiology , Arteriovenous Malformations/complications , Brain/blood supply , Brain/diagnostic imaging , Cerebral Arteries/diagnostic imaging , Cerebral Veins/diagnostic imaging , Humans , Male , Middle Aged , Technetium Tc 99m Exametazime , Tomography, Emission-Computed, Single-PhotonABSTRACT
OBJECTIVE: The purpose of this study was to assess the safety and effectiveness of uterine artery embolization using gelatin sponge particles alone for women with symptomatic uterine fibroids. SUBJECTS AND METHODS: During 38 months, 60 patients (age range, 32-52 years; mean age, 42.5 years) with symptomatic uterine fibroids underwent uterine artery embolization. Only gelatin sponge particles, approximately 500-1000 microm in diameter, were used in all patients. The improvement of clinical symptoms was assessed by questionnaire. Reduction of the largest tumor and uterine volume reductions were assessed using MR imaging. The follow-up period ranged from 1 to 38 months (mean, 10.6 months). RESULTS: Menorrhagia improved markedly or moderately in 41 (98%) of 42 of patients 4 months after embolization and in 20 (100%) of 20 patients 1 year after embolization. Bulk-related symptoms improved markedly or moderately in 31 (97%) of 32 of patients 4 months after embolization and in 19 (100%) of 19 of patients 1 year after embolization. MR imaging revealed that the mean largest tumor volume reduction rates were 55% at 4 months and 70% at 1 year after embolization, and the mean uterine volume reduction rates were 40% at 4 months and 56% at 1 year after embolization. Follow-up MR imaging showed no new fibroids and no regrowth of existing fibroids. No major complications were observed in any women. CONCLUSION: We suggest that uterine artery embolization with gelatin sponge particles alone is a safe and effective treatment for symptomatic fibroids. The outcomes bear comparison with those of uterine artery embolization using polyvinyl alcohol particles, which have been reported in the literature.
