Susceptibility weighted MRI after uterine artery embolization for leiomyoma

• Published in: Magnetic resonance imaging Vol. 58; pp. 32 - 37
• Main Authors: Yamahana, Yasuyuki, Katsumori, Tetsuya, Miura, Hiroshi, Asai, Shunsuke, Yamada, Sachimi, Takahata, Akiko, Yamada, Kei
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.05.2019
• Subjects: Fibroid; Leiomyoma; Magnetic resonance imaging; Suceptibility weighted imaging; Uterine artery embolization; Uterus; Leiomyoma; Magnetic resonance imaging; Uterus; Uterine artery embolization; Fibroid; Suceptibility weighted imaging
• ISSN: 0730-725X; 1873-5894
• DOI: 10.1016/j.mri.2019.01.013

To evaluate whether susceptibility-weighted MR imaging (SWI) findings are associated with tumor infarction on contrast-enhanced MRI (CE-MRI) after uterine artery embolization (UAE) for leiomyoma. This was a single institution, retrospective study. Between February 2016 and April 2017, 27 consecutive patients underwent UAE and completed SWI and CE-MRI before and 1 week after UAE. Two blinded readers independently reviewed the MRI of 261 tumors ≥1 cm in all patients. We evaluated the relationship between the hypointense peripheral rim observed on the tumor surface on post-procedural SWI and the infarction rates (≥90%, <90%) of each tumor based on post-procedural CE-MRI. Inter-reader correlation coefficients (ICC) and the sensitivity and specificity of the rim were measured. Substantial inter-reader agreement was noted in post-procedural SWI interpretations (ICC = 0.681, 95% CI; 0.547, 0.771). The rim was observed in 66.7% (174/261) of tumors by reader 1 and 55.9% (146/261) of tumors by reader 2 on post-procedural SWI. Correlations were observed between the rim and ≥90% tumor infarction by readers 1 and 2 (Spearman's coefficient = 0.474 and 0.438, p < 0.001 and p < 0.001, respectively). The sensitivity and specificity of the rim to tumor infarction were 77.2 and 82.6% (reader 1), and 65.8 and 100% (reader 2), respectively. The present study demonstrated that the hypointense peripheral rim was observed on some leiomyomas on SWI immediately after UAE. The rim correlated with tumor infarction on post-procedural CE-MRI. This SWI finding was helpful for evaluating embolic effects on leiomyomas in the acute phase after UAE.