Fibroid perfusion

In addition, the degree of gadolinium enhancement is not correlated with fibroid volume reduction [35, 37]. Therefore, these data suggest that ultrasound may not be useful for the imaging follow-up particularly in patients who have recurrent symptoms [37]. This observation may change if a more accurate means than color Doppler is developed to assess residual fibroid perfusion with ultrasound [38,39]. 

The best imaging to evaluate the perfusion and size/ volume of the fibroids following the procedure is MR. The timing of the imaging is not standardized. In our practice we typically image at 6 months which gives a chance for the fibroids to have changed in volume and offers the patient an opportunity to... 

Fig. 10.4.2a,b. A 45-year-old woman with fibroid-related menorrhagia, a Pre-embolization sagittal contrast-enhanced MRl shows a single hypervascular intramural fibroid (F). b Post-embolization contrast-enhanced MRl obtained 3 months after embolization demonstrates a complete devascularization of the embolized fibroid with a normal myometrial perfusion The patient s condition has also greatly improved... 

Appropriate patient selection, careful catheterization and knowledge of different anatomic variants are important factors to minimize the failure after UFE. Systematic use of contrast-enhanced MRI is therefore essential, not only prior to the procedure, but also to monitor the perfusion of fibroids after... 

Pelage JP, Brouard R, Jacob D, Boudiaf M, Abitbol M, Le Dref O (2004) Perfusion of uterine fibroids evaluated using contrast-ehanced magentic resonance imaging performed 24 hours after embolization is a predictor of clinical outcome [abstract]. Radiology (P) 613... 

Embolization of the uterine artery induces infarction of fibroids while uterine perfusion is maintained [84,119]. Infarction leads to coagulation necrosis and subsequent complete hyalinization of the fibroids [27, 119,211]. further transformations cause softening and shrinkage of the tumors. Eollow-up for 3-24 months has shown that there is an average size reduction of the uter-... 

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